MEDICARE: ALEXANDER KIEU 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	207Q00000X	Family Medicine Physician	04-38300	KS

General Provider Information

NPI Number	:	1912269069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER KIEU M.D.

Provider Business Mailing Address
First Line	:	721 N 31ST ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-3964
Country	:	US
Telephone Number	:	913-621-0074
Fax Number	:	913-621-1996

Provider Business Practice Location Address
First Line	:	721 N 31ST ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-3964
Country	:	US
Telephone Number	:	913-621-0074
Fax Number	:	913-621-1996

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

Provider Enumeration Date	:	06/14/2012
Last Update Date	:	12/12/2016

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