Provider Demographics
NPI:1346237088
Name:KLOSTER, DANIEL R (M D)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:KLOSTER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7100 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1862
Mailing Address - Country:US
Mailing Address - Phone:913-242-7570
Mailing Address - Fax:913-242-7572
Practice Address - Street 1:5701 W 119TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:913-498-6124
Practice Address - Fax:913-498-6117
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO118941208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208858621Medicaid
KS7905560001OtherDME
MO073057OtherFHP MEDICAID
MO26073028OtherBCBS OF KANSAS CITY
G80285Medicare UPIN
MOL477920Medicare PIN
MO073057OtherFHP MEDICAID