MEDICARE: MIDWEST CERTIFIED FIRST ASSISTANTS

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	246ZC0007X	Surgical Assistant	06-302	MO

General Provider Information

NPI Number	:	1760659734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST CERTIFIED FIRST ASSISTANTS

Provider Business Mailing Address
First Line	:	7619 E 76TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64138-1121
Country	:	US
Telephone Number	:	816-358-4316
Fax Number	:

Provider Business Practice Location Address
First Line	:	7619 E 76TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64138-1121
Country	:	US
Telephone Number	:	816-358-4316
Fax Number	:

Authorized Official
Title or Position	:	CERTIFIED FIRST ASSISTANT
Name	:	MR. ROBERT ANTHONY EVERETTE
Credential	:	SA-C
Telephone Number	:	816-358-4316

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	05/09/2008

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Directions to “MIDWEST CERTIFIED FIRST ASSISTANTS ” Practice Location

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