Provider Demographics
NPI:1316364573
Name:HAERI, MOHAMMAD (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:HAERI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:SEYED MOHAMMAD
Other - Middle Name:
Other - Last Name:HAERI HOSSEINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4000 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-1101
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-3411
Practice Address - Country:US
Practice Address - Phone:913-588-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty