1386962595 NPI number — MRS. PAMELA S CARTER AA

Table of content: MRS. PAMELA S CARTER AA (NPI 1386962595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386962595 NPI number — MRS. PAMELA S CARTER AA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
PAMELA
Provider Middle Name:
S
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BINA
Provider Other First Name:
PAMELA
Provider Other Middle Name:
S
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
AA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386962595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9233 WARD PKWY
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64114-3366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-389-6030
Provider Business Mailing Address Fax Number:
816-389-6034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 WORNALL RD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF CARDIOTHORACIC ANESTHESIA
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-3220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-389-6030
Provider Business Practice Location Address Fax Number:
816-389-6034
Provider Enumeration Date:
05/12/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2010015648 . This is a "2010015648- STATE LICENSE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".