Basic Information
| Provider Information | |||||||||
| NPI: | 1396956421 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UMKC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8824 W 77TH ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662042527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7089454868 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4401 WORNALL RD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169322000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 03/26/2012 | ||||||||
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| AuthorizedOfficialLastName: | HAMARSHI | ||||||||
| AuthorizedOfficialFirstName: | MAJDI | ||||||||
| AuthorizedOfficialMiddleName: | SM | ||||||||
| AuthorizedOfficialTitleorPosition: | FELLOW | ||||||||
| AuthorizedOfficialTelephone: | 7089454868 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.