Provider Demographics
NPI:1962497016
Name:ALM, KATHLEEN A (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:ALM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:17221 E 23RD ST S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1803
Mailing Address - Country:US
Mailing Address - Phone:816-350-0005
Mailing Address - Fax:816-350-0015
Practice Address - Street 1:17221 E 23RD ST S
Practice Address - Street 2:SUITE 100
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1803
Practice Address - Country:US
Practice Address - Phone:816-350-0005
Practice Address - Fax:816-350-0015
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOMD R3C34207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100452500AMedicaid
MO202186201Medicaid
MO202186201Medicaid
MOC50484Medicare UPIN