Fedotin, Michael S

Fedotin, Michael S is an individual health care provider with primary practice located at 2330 E Meyer Blvd Suite 301, Kansas City MO 64132-1132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Fedotin, Michael S can be contacted via phone (816) 333-5424.

Contact Information

Primary practice address
2330 E Meyer Blvd Suite 301 Kansas City MO 64132-1132
Phone: (816) 333-5424
Fax: (816) 822-0870
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X R3526 Missouri
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 14275 Kansas

Profile Details

NPI number 1447256037
LBN Legal business name Fedotin, Michael S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Jan 25th, 2016 - about 9 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 1447256037 NPPES
Missouri MEDICAID 200079309
Missouri Other 100003018
Missouri MEDICAID 100005900A

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