Basic Information
| Provider Information | |||||||||
| NPI: | 1497856819 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARTAMIAN | ||||||||
| FirstName: | KRIKOR | ||||||||
| MiddleName: | O. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 803886 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641803886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162328877 | ||||||||
| FaxNumber: | 8162320307 | ||||||||
| Practice Location | |||||||||
| Address1: | 2303 VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645064954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162326818 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 34879 | MO | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 340006078 | 01 | MO | MEDICARE RAILROAD | OTHER | 04306021 | 01 | MO | BLUE CROSS BLUE SHIELD KC | OTHER | C51740 | 01 | MO | UPIN | OTHER | 200376325 | 05 | MO | MEDICAID |