Provider Demographics
NPI:1922084490
Name:LITWIN, KEVIN L (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:L
Last Name:LITWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 802813
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0001
Mailing Address - Country:US
Mailing Address - Phone:913-491-0413
Mailing Address - Fax:770-237-4981
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:RESEARCH HOSPITAL-RADIOLOGY DEPT.
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1136
Practice Address - Country:US
Practice Address - Phone:816-276-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010236072085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G796300OtherBLUE SHIELD
KS100425160CMedicaid
MOP00343086OtherRAILROAD MEDICARE
MO205771819Medicaid
MO1528169752OtherSECOND NPI NUMBER FOR MEDICARE GROUP # I23000A
MO1528169752OtherSECOND NPI NUMBER FOR MEDICARE GROUP # I23000A
00G796300OtherBLUE SHIELD
MOI23B353Medicare PIN