Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 108184 | MO |
NPI | 1225095821 |
---|---|
Provider Name | Dr. Stephen Farrell Kaine |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 13/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208023002 | (05) | MO |
F75344 | (02) |