Provider Demographics
NPI:1548207087
Name:NORTHWEST MISSOURI PATHOLOGISTS, M.D., P.C.
Entity Type:Organization
Organization Name:NORTHWEST MISSOURI PATHOLOGISTS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-271-6170
Mailing Address - Street 1:PO BOX 412868
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-2868
Mailing Address - Country:US
Mailing Address - Phone:800-897-6169
Mailing Address - Fax:800-897-6170
Practice Address - Street 1:5325 FARAON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3488
Practice Address - Country:US
Practice Address - Phone:816-271-6170
Practice Address - Fax:816-271-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CS8770OtherRAILROAD MEDICARE
KS100212990AMedicaid
10225013OtherBLUE CROSS BLUE SHIELD KC
MO502207608Medicaid
MO502207608Medicaid