MEDICARE: MICHAEL L. WALDSCHMIDT 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	2086S0129X	Vascular Surgery Physician	R2E49	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

General Provider Information

NPI Number	:	1811995129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L. WALDSCHMIDT M.D.

Provider Business Mailing Address
First Line	:	2750 CLAY EDWARDS DR STE 304
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-3256
Country	:	US
Telephone Number	:	816-842-5555
Fax Number	:	816-842-8888

Provider Business Practice Location Address
First Line	:	2521 GLENN HENDREN DR
Second Line	:	SUITE 112
City	:	LIBERTY
State	:	MO
Zip	:	64068-3388
Country	:	US
Telephone Number	:	816-842-5555
Fax Number	:	816-842-8888

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	12/15/2016

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