Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 2014016780 | MO |
NPI | 1023246311 |
---|---|
Provider Name | Susan Sifers |
First Address | Kansas City, MO 64131 |
Second Address | Kansas City, MO 64111-3498 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 15/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023246311 | (05) | MO |