Provider Demographics
NPI:1700998135
Name:CAIN, SHARON E (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:CAIN
Suffix:
Gender:F
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 411851
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1851
Mailing Address - Country:US
Mailing Address - Phone:913-588-6492
Mailing Address - Fax:913-588-6414
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:4019 DELP, MAIL STOP 4017
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-6492
Practice Address - Fax:913-588-6414
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21991174400000X
MOR4H86174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100152150DMedicaid