MEDICARE: CHRIS JAMES MAEDA M.D.

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	174400000X	Specialist
2	207X00000X	Orthopaedic Surgery Physician	R8C98	MO

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
2	742006020	OTHER	MO	TAX ID #
3	13910016	OTHER	MO	MO BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730188418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS JAMES MAEDA M.D.

Provider Business Mailing Address
First Line	:	4320 WORNALL RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3235
Country	:	US
Telephone Number	:	816-931-2105
Fax Number	:	816-931-0509

Provider Business Practice Location Address
First Line	:	4320 WORNALL RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3235
Country	:	US
Telephone Number	:	816-931-2105
Fax Number	:	816-931-0509

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	08/08/2016

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