Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | R3H36 | MO |
NPI | 1023076072 |
---|---|
Provider Name | Timothy M Bateman |
First Address | Kansas City, MO 64111-5939 |
Second Address | Kansas City, MO 64111-5939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 31/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C35460 | (02) |