Provider Demographics
NPI:1710971411
Name:STAMOS, GEORGE E (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:E
Last Name:STAMOS
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 1:10601 QUIVIRA RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2310
Mailing Address - Country:US
Mailing Address - Phone:913-541-3340
Mailing Address - Fax:913-492-7857
Practice Address - Street 1:10601 QUIVIRA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2310
Practice Address - Country:US
Practice Address - Phone:913-541-3340
Practice Address - Fax:913-492-7857
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17080207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100092790CMedicaid
KS04-17080OtherMEDICAL LICENSE
MO1710971411Medicaid
KS100092790CMedicaid
KSS292682Medicare PIN