Provider Demographics
NPI:1669497202
Name:FAST, ROBERT EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWARD
Last Name:FAST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17793 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002
Mailing Address - Country:US
Mailing Address - Phone:816-262-5917
Mailing Address - Fax:816-271-6423
Practice Address - Street 1:901 HEARTLAND RD
Practice Address - Street 2:SUITE 2800
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-6200
Practice Address - Country:US
Practice Address - Phone:816-271-1213
Practice Address - Fax:816-271-6423
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-16292207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10001243601OtherCOMMUNITY HEALTH PLAN
MO18257025OtherBLUE CROSS BLUE SHIELD
210633OtherHEALTHLINK
MO463839OtherCHILDRENS MERCY FAMILY HEALTH
P00036159OtherRAILROAD MEDICARE
MO203288204Medicaid
44054528964506V016OtherTRICARE/CHAMPUS
602270OtherFIRSTGUARD
4571202OtherAETNA
KS100132140BMedicaid
210633OtherHEALTHLINK
MO203288204Medicaid
4571202OtherAETNA