Basic Information
Provider Information
NPI: 1841556859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KWASINSKI
FirstName: DAVID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 843966
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641843966
CountryCode: US
TelephoneNumber: 5738843300
FaxNumber: 5738840943
Practice Location
Address1: 1 HOSPITAL DR RM 3W-27
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652120001
CountryCode: US
TelephoneNumber: 5738822568
FaxNumber: 5738822226
Other Information
ProviderEnumerationDate: 04/03/2012
LastUpdateDate: 02/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X2018002972MOY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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