Provider Demographics
NPI:1154305480
Name:NOSTI, JUAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:C
Last Name:NOSTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 W 74TH ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2204
Mailing Address - Country:US
Mailing Address - Phone:913-262-5014
Mailing Address - Fax:913-262-6198
Practice Address - Street 1:8901 W 74TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2204
Practice Address - Country:US
Practice Address - Phone:913-262-5014
Practice Address - Fax:913-262-6198
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-150822082S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO05641013OtherBLUE CROSS BLUE SHIELD KC
KS056987OtherBCBS KANSAS
KS100093180AMedicaid
KS056987OtherBCBS KANSAS