Provider Demographics
NPI:1750370540
Name:MIR, ABDUL RAUF (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:RAUF
Last Name:MIR
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 1:6400 PROSPECT AVE
Mailing Address - Street 2:SUITE 480
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1100
Mailing Address - Country:US
Mailing Address - Phone:816-276-1700
Mailing Address - Fax:816-444-2810
Practice Address - Street 1:6400 PROSPECT AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1100
Practice Address - Country:US
Practice Address - Phone:816-276-1700
Practice Address - Fax:816-444-2810
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35037207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3734038Medicare ID - Type Unspecified
E24094Medicare UPIN