Provider Demographics
NPI:1265570055
Name:KANSAS HEART AND LUNG SURGERY, CHARTERED
Entity type:Organization
Organization Name:KANSAS HEART AND LUNG SURGERY, CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCIOLARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-660-0438
Mailing Address - Street 1:8919 PARALLEL PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1636
Mailing Address - Country:US
Mailing Address - Phone:913-660-0438
Mailing Address - Fax:
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1636
Practice Address - Country:US
Practice Address - Phone:913-660-0438
Practice Address - Fax:913-676-6059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS426585208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00062298OtherRAILROAD MEDICARE
33222014OtherBLUE CROSS BLUE SHIELD
33222014OtherBLUE CROSS BLUE SHIELD
MOP890000Medicare ID - Type Unspecified