Provider Demographics
NPI:1932326071
Name:CATAUSAN, MICHAEL TINAMISAN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TINAMISAN
Last Name:CATAUSAN
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 1:4050 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 115 #96
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3041
Mailing Address - Country:US
Mailing Address - Phone:913-827-7273
Mailing Address - Fax:
Practice Address - Street 1:533 N MUR LEN RD STE B
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1221
Practice Address - Country:US
Practice Address - Phone:913-827-7273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6623207Q00000X
KS04-32543207Q00000X
MO2009032076207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine