Provider Demographics
NPI:1801866769
Name:KRUMM, BERENT JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BERENT
Middle Name:JAMES
Last Name:KRUMM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9411 N OAK TRFY
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-436-7072
Mailing Address - Fax:816-436-2743
Practice Address - Street 1:9411 N OAK TRFY
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2262
Practice Address - Country:US
Practice Address - Phone:816-436-1800
Practice Address - Fax:816-436-4241
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-10-22
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Provider Licenses
StateLicense IDTaxonomies
MO2001009171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
29728013OtherBCBS OF KC INDIVIDUAL #
086B197AMedicare PIN
H44028Medicare UPIN