Provider Demographics
NPI:1598967655
Name:PAWSAT & MAEDA MD PC
Entity Type:Organization
Organization Name:PAWSAT & MAEDA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-931-2105
Mailing Address - Street 1:4320 WORNALL RD STE 312
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3245
Mailing Address - Country:US
Mailing Address - Phone:816-931-2105
Mailing Address - Fax:816-931-0509
Practice Address - Street 1:4320 WORNALL RD STE 312
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3245
Practice Address - Country:US
Practice Address - Phone:816-931-2105
Practice Address - Fax:816-931-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
200008836OtherMEDICARE RAILROAD
KS100117180AMedicaid
MO502548100Medicaid
MO07709017OtherBLUE SHIELD
MO07709017OtherBLUE SHIELD
MO4910000Medicare ID - Type Unspecified
MO502548100Medicaid