| Midwest Geriatric Psychiatric Services Pc | |
|
5900 Swope Pkwy Kansas City MO 64130-4241 | |
| (816) 333-2700 | |
| Not Available |
| Full Name | Midwest Geriatric Psychiatric Services Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5900 Swope Pkwy, Kansas City, Missouri |
| Authorized Official Name and Position | Sankar Reddy Kodidhi (PRESIDENT) |
| Authorized Official Contact | 8168754400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Geriatric Psychiatric Services Pc 900 Sw 33rd St Lees Summit MO 64082-4191 Ph: (816) 875-4400 | Midwest Geriatric Psychiatric Services Pc 5900 Swope Pkwy Kansas City MO 64130-4241 Ph: (816) 333-2700 |
| NPI Number | 1093144917 |
|---|---|
| Provider Enumeration Date | 11/01/2013 |
| Last Update Date | 11/04/2013 |
| Medicare PECOS PAC ID | 0143459826 |
|---|---|
| Medicare Enrollment ID | O20140128001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093144917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0015X | Psychiatry & Neurology - Psychosomatic Medicine | 2005031801 (Missouri) | Primary |
| Provider Name | Sankar R Kodidhi |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1043265432 PECOS PAC ID: 3072516806 Enrollment ID: I20060817000300 |
| Provider Name | Chijioke F Mbah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376152546 PECOS PAC ID: 1153731955 Enrollment ID: I20201106000394 |
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