Provider Demographics
NPI:1821070905
Name:CEDERLIND, CRANSTON JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:CRANSTON
Middle Name:JAY
Last Name:CEDERLIND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14095
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66285-4095
Mailing Address - Country:US
Mailing Address - Phone:913-888-6310
Mailing Address - Fax:913-888-4710
Practice Address - Street 1:421 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032-1334
Practice Address - Country:US
Practice Address - Phone:785-448-3131
Practice Address - Fax:785-448-5725
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-15034207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100333710BMedicaid
KS160053740OtherRAILROAD MEDICARE
KS614623OtherFIRSTGUARD HEALTH PLAN
MO09194024OtherBCBS OF KANSAS CITY
KS100333710BMedicaid
KS6063993Medicare PIN