Provider Demographics
NPI:1932118106
Name:CWL INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:CWL INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:WOODS
Authorized Official - Last Name:LEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-943-6123
Mailing Address - Street 1:1010 CARONDELET DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4859
Mailing Address - Country:US
Mailing Address - Phone:816-943-6123
Mailing Address - Fax:816-942-3045
Practice Address - Street 1:1010 CARONDELET DR
Practice Address - Street 2:SUITE 105
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4859
Practice Address - Country:US
Practice Address - Phone:816-943-6123
Practice Address - Fax:816-942-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
110216357OtherRAILROAD MEDICARE
MO40048013OtherBLUECROSS BLUESHIELD OF KANSAS CITY
MO40048013OtherBLUECROSS BLUESHIELD OF KANSAS CITY
110216357OtherRAILROAD MEDICARE