Provider Demographics
NPI:1851456990
Name:ROSBRUGH, IAN M (MD)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:M
Last Name:ROSBRUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2790 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 530
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3276
Mailing Address - Country:US
Mailing Address - Phone:816-452-3300
Mailing Address - Fax:816-453-0677
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 530
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-452-3300
Practice Address - Fax:816-453-0677
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2016-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2007011591207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1851456990Medicaid
MO1851456990Medicaid