Provider Demographics
NPI:1629061635
Name:GUSS, SALOMON L (MD)
Entity Type:Individual
Prefix:
First Name:SALOMON
Middle Name:L
Last Name:GUSS
Suffix:
Gender:M
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:PO BOX 12030
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66282-2030
Mailing Address - Country:US
Mailing Address - Phone:913-381-9260
Mailing Address - Fax:913-383-8336
Practice Address - Street 1:1001 6TH AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-3222
Practice Address - Country:US
Practice Address - Phone:913-682-7705
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-22451207K00000X
MOR1J94207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS45180Medicare ID - Type Unspecified
F49321Medicare UPIN