Provider Demographics
NPI:1841419280
Name:STAMATI, MIGUEL ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:STAMATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 SOMERSET DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5217
Mailing Address - Country:US
Mailing Address - Phone:913-488-8160
Mailing Address - Fax:913-538-2526
Practice Address - Street 1:4200 SOMERSET DR
Practice Address - Street 2:SUITE 214
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5217
Practice Address - Country:US
Practice Address - Phone:913-488-8160
Practice Address - Fax:913-538-2526
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-259902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSF20820Medicare UPIN