MEDICARE: JAMES BRYAN WOHLWEND 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	208000000X	Pediatrics Physician	04-31262	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	:	1720051220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BRYAN WOHLWEND MD

Provider Business Mailing Address
First Line	:	9405 N. OAK TRAFFICWAY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155
Country	:	US
Telephone Number	:	816-412-2900
Fax Number	:	816-412-2915

Provider Business Practice Location Address
First Line	:	9405 N. OAK TRAFFICWAY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155
Country	:	US
Telephone Number	:	816-412-2900
Fax Number	:	816-412-2915

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	01/05/2016

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