Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2013012517 | MO |
N | 111NI0900X | Internist | 2013012517 | MO |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2013012517 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 2013012517 | MO |
NPI | 1639490030 |
---|---|
Provider Name | Dr. Timothy J Fendler |
First Address | Kansas City, MO 64131-4517 |
Second Address | Lees Summit, MO 64086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2010 |
Last Update Date | 28/08/2020 |