Provider Demographics
NPI:1073709564
Name:PAMELA SEATOR MD LLC
Entity Type:Organization
Organization Name:PAMELA SEATOR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEATOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-268-6996
Mailing Address - Street 1:9229 WARD PKWY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3311
Mailing Address - Country:US
Mailing Address - Phone:816-268-6996
Mailing Address - Fax:816-822-8058
Practice Address - Street 1:9229 WARD PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3311
Practice Address - Country:US
Practice Address - Phone:816-268-6996
Practice Address - Fax:816-822-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21382261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST910000Medicare PIN