Provider Demographics
NPI:1740233766
Name:INTERNAL MEDICINE PHYSICIANS, INC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUSICANT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:816-737-3800
Mailing Address - Street 1:4240 BLUE RIDGE BLVD
Mailing Address - Street 2:SUITE 725
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-1713
Mailing Address - Country:US
Mailing Address - Phone:816-737-3800
Mailing Address - Fax:816-737-5636
Practice Address - Street 1:4240 BLUE RIDGE BLVD
Practice Address - Street 2:SUITE 725
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1713
Practice Address - Country:US
Practice Address - Phone:816-737-3800
Practice Address - Fax:816-737-5636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO07460018OtherBC AND BS OF KANSAS CITY
KS11021254AMedicaid
MO1710000Medicare ID - Type Unspecified