Provider Demographics
NPI:1528000429
Name:SLY, ANNE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 TROOST AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1215
Mailing Address - Country:US
Mailing Address - Phone:816-276-7600
Mailing Address - Fax:
Practice Address - Street 1:6650 TROOST AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1215
Practice Address - Country:US
Practice Address - Phone:816-276-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9490207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201019551Medicaid
KS100179970BMedicaid
MOC51086Medicare UPIN
KS100179970BMedicaid
MO201019551Medicaid