Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000679 | MO |
Y | 222Z00000X | Podiatrist | 000679 | MO |
NPI | 1033147277 |
---|---|
Provider Name | Dr. Michael Neil Fine |
First Address | N Kansas City, MO 64116-3276 |
Second Address | N Kansas City, MO 64116-3276 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 30/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083821904 | GROUP NPI NUMBER (01) | MO |
22440035 | BCBS (01) | MO |
308093905 | (05) | MO |
480033263 | MEDICARE RAILROAD (01) | MO |
U49909 | (02) | MO |