Provider Demographics
NPI:1235227901
Name:VANMORLAN, AMIE MARGETT (MD)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:MARGETT
Last Name:VANMORLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:AMIE
Other - Middle Name:MARGETT
Other - Last Name:CASELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:404 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6626
Practice Address - Country:US
Practice Address - Phone:573-882-6979
Practice Address - Fax:573-884-8823
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040127752080P0205X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200371580AMedicaid
MO207582503Medicaid
MOI50961Medicare UPIN
KS200371580AMedicaid
269E466Medicare ID - Type Unspecified