Fanning, Martha Sue

Fanning, Martha Sue is an individual health care provider with primary practice located at 12300 Metcalf Ave , Overland Park KS 66213-1324. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Fanning, Martha Sue can be contacted via phone (913) 317-7485.

Contact Information

Primary practice address
12300 Metcalf Ave Overland Park KS 66213-1324
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 04-26640 Kansas

Profile Details

NPI number 1073514733
LBN Legal business name Fanning, Martha Sue
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Jun 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073514733 NPPES
Kansas MEDICAID 100333210C
Kansas Other 24548088
Kansas Other 01674018
Kansas MEDICAID 100333210E
Kansas Other 24548068
Kansas Other P00278183
Kansas MEDICAID 208531038
Kansas Other 930072754

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