Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2019036151 | MO |
NPI | 1457440513 |
---|---|
Provider Name | Dr. Kenneth A Zaremski |
First Address | Gladstone, MO 64118-3756 |
Second Address | Kansas City, MO 64132-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 05/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201270059 | TAX ID (01) | MI |