Provider Demographics
NPI:1225061344
Name:HALEEM, USMAN (MD)
Entity Type:Individual
Prefix:
First Name:USMAN
Middle Name:
Last Name:HALEEM
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 1:901 E. 104TH ST.
Mailing Address - Street 2:MAILSTOP 400N
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-9712
Mailing Address - Country:US
Mailing Address - Phone:816-502-7104
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:20 NE SAINT LUKES BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6003
Practice Address - Country:US
Practice Address - Phone:816-347-5100
Practice Address - Fax:816-347-5136
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111283207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204805725Medicaid
MOH74A253Medicare ID - Type Unspecified