Provider Demographics
NPI:1689614752
Name:HUSEMAN, RICHARD ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALLAN
Last Name:HUSEMAN
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 1:8901 W 74TH STREET
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-831-2430
Mailing Address - Fax:913-831-0108
Practice Address - Street 1:8901 W 74TH STREET
Practice Address - Street 2:SUITE 120
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-831-2430
Practice Address - Fax:913-831-0108
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7110207R00000X
KS0416306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100351340AMedicaid
608698OtherBCKS
06243020OtherBCKC
MOHU201275914Medicaid
KS100351340AMedicaid
06243020OtherBCKC
C50325Medicare UPIN