Provider Demographics
NPI:1952409039
Name:SCIARA, ROSS A (DO)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:A
Last Name:SCIARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 NW BRIARCLIFF PKWY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1668
Mailing Address - Country:US
Mailing Address - Phone:816-838-1492
Mailing Address - Fax:
Practice Address - Street 1:502 NW BRIARCLIFF PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1668
Practice Address - Country:US
Practice Address - Phone:816-838-1492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5617207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB91180Medicare UPIN