Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RP1001X | Pulmonary Disease | 0416216 | KS |
Y | 207RP1001X | Pulmonary Disease | R9215 | MO |
NPI | 1033175062 |
---|---|
Provider Name | Dr. Thomas A Beller |
First Address | Kansas City, MO 64132 |
Second Address | Kansas City, MO 64132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 10/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100195730A | (05) | KS |
201193109 | (05) | MO |
C51614 | (02) |