Croom, Angela J

Croom, Angela J is an individual health care provider with primary practice located at 5808 W 110Th St , Overland Park KS 66211-2504. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Croom, Angela J can be contacted via phone (913) 696-8746.

Contact Information

Primary practice address
5808 W 110Th St Overland Park KS 66211-2504
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 160504 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0431871 Kansas

Profile Details

NPI number 1891779906
LBN Legal business name Croom, Angela J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Jun 22nd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891779906 NPPES
Missouri MEDICAID 201431202
Missouri MEDICAID 200388210A
Missouri MEDICAID 3197263

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