MEDICARE: DR. SUBBU JOSEPH SARMA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	2003010751	MO
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	04-31941	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689661829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUBBU JOSEPH SARMA MD

Provider Business Mailing Address
First Line	:	4741 CENTRAL ST # 132
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64112-1533
Country	:	US
Telephone Number	:	816-809-1715
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 NE LAKEWOOD WAY STE 210
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64064-2059
Country	:	US
Telephone Number	:	816-554-7750
Fax Number	:	816-554-7866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	10/19/2021

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