Provider Demographics
NPI:1912998329
Name:MURILLO, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MURILLO
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 328
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1100
Mailing Address - Country:US
Mailing Address - Phone:816-822-8257
Mailing Address - Fax:816-822-8259
Practice Address - Street 1:6400 PROSPECT AVE
Practice Address - Street 2:SUITE 328
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1100
Practice Address - Country:US
Practice Address - Phone:816-822-8257
Practice Address - Fax:816-822-8259
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003027453204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203969217Medicaid
MOF65376Medicare UPIN
MOQ908463Medicare ID - Type Unspecified