Provider Demographics
NPI:1043579410
Name:MAIDMENT, BERTRAM W III (MD)
Entity Type:Individual
Prefix:
First Name:BERTRAM
Middle Name:W
Last Name:MAIDMENT
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:6601 WINCHESTER AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4681
Mailing Address - Country:US
Mailing Address - Phone:816-313-2677
Mailing Address - Fax:816-313-6000
Practice Address - Street 1:6601 WINCHESTER AVE STE 230
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-4681
Practice Address - Country:US
Practice Address - Phone:816-313-2677
Practice Address - Fax:816-313-6000
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-399792085R0001X
MO20170141812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology