Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2015027609 | MO |
NPI | 1154402014 |
---|---|
Provider Name | Dr. Wasse Zafer |
First Address | Grandview, MO 64030-1100 |
Second Address | Grandview, MO 64030-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 23/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18204014 | BLUE CROSS KANSAS CITY (01) | KS |
4408060 | UNITED HEALTH CARE (01) | KS |
4472922 | AETNA (01) | KS |
497480 | BLUECROSS KS INDIVIDUAL (01) | KS |
520675 | (05) | KS |
742825920 | TAX ID (01) | KS |
U31240 | (02) | KS |