Liveactive Multispecialty Physician Group LLC
Internal Medicine in Overland Park, KS. Organization (NPI-2).
NPI number1558093575
StatusActive
Last updated in NPPESJun 28, 2022
Details
- NPI
- 1558093575
- Entity type
- Organization (NPI-2)
- Legal business name
- Liveactive Multispecialty Physician Group LLC
- Organization subpart
- No
- Enumeration date
- Jun 28, 2022
- Certification date
- May 27, 2022
- Last updated
- Jun 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – |
Practice location
6650 W 110th StreetSuite 220a
Overland Park, KS 66211
Phone 913-549-3884 · Fax 913-273-3343
Mailing address
7111 W 151st St Ste 303Overland Park, KS 66223-2231
Phone 913-549-3884 · Fax 913-273-3343
Authorized official
Haseeb Ahmed
Owner
9135493884
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