MEDICARE: ADEEL PERVEZ 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	2013029752	MO
2	207RP1001X	Pulmonary Disease Physician	2013029752	MO
3	207RP1001X	Pulmonary Disease Physician	MD425350	PA
4	207RS0012X	Sleep Medicine (Internal Medicine) Physician	2013029752	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2695847	OTHER	PA	BLUE SHIELD

General Provider Information

NPI Number	:	1710933825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEEL PERVEZ MD

Provider Business Mailing Address
First Line	:	206 NW MOCK AVE STE 200
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2530
Country	:	US
Telephone Number	:	816-416-8635
Fax Number	:	816-416-8651

Provider Business Practice Location Address
First Line	:	206 NW MOCK AVE STE 200
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2530
Country	:	US
Telephone Number	:	816-416-8633
Fax Number	:	816-416-8644

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	02/16/2022

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