| Midc | |
|
2340 E Meyer Blvd, Bldg 2 Ste 392 Kansas City MO 64132-1129 | |
| (816) 444-7977 | |
| (816) 361-8938 |
| Full Name | Midc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 2340 E Meyer Blvd, Bldg 2, Kansas City, Missouri |
| Authorized Official Name and Position | Russell M Petrak (MANAGING PARTNER) |
| Authorized Official Contact | 8882206432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midc 901 Mcclintock Dr Ste 202 Burr Ridge IL 60527-0872 Ph: (888) 220-6432 | Midc 2340 E Meyer Blvd, Bldg 2 Ste 392 Kansas City MO 64132-1129 Ph: (816) 444-7977 |
| NPI Number | 1598242778 |
|---|---|
| Provider Enumeration Date | 07/20/2018 |
| Last Update Date | 07/15/2021 |
| Certification Date | 07/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598242778 | NPI | - | NPPES |
| 502397706 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (Missouri) | Primary |
Plaza Primary Care and Geriatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Broadway, Kansas City, MO 64111 Phone: 816-561-9200 Fax: 816-561-5766 |
Bannister Internal Medicine Clinic, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9520 James A Reed Rd, Suite B, Kansas City, MO 64134 Phone: 816-599-6317 Fax: 816-599-6319 |
Elevating Care Clinic, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2340 E. Meyer Blvd, 208, Kansas City, MO 64132 Phone: 816-665-6124 |
Afya Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2319 E 12th St, Kansas City, MO 64127 Phone: 816-824-7219 |
Gateway Spine and Joint LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 W 47th St Ste 514, Kansas City, MO 64112 Phone: 816-216-7054 Fax: 816-216-6010 |
Midwest Neurosurgery Associates, PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6420 Prospect Ave, Suite T411, Kansas City, MO 64132 Phone: 816-363-2500 Fax: 816-363-8741 |