Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2017018231 | MO |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 2017018231 | MO |
NPI | 1306139282 |
---|---|
Provider Name | Andrew Palmisano |
First Address | Kansas City, MO 64131-4517 |
Second Address | Lees Summit, MO 64086-6011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 09/08/2019 |