Theoharidis, Akilis Mike
Theoharidis, Akilis Mike is an individual health care provider with primary practice located at 407 Ne 76Th Ter , Gladstone MO 64118-1708. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot Surgery is his primary health care specialty. Theoharidis, Akilis Mike can be contacted via phone (816) 436-7900.Contact Information
Primary practice address
407 Ne 76Th Ter
Gladstone MO 64118-1708
Phone: (816) 436-7900
Fax: (816) 436-0999
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 000747 | Missouri |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | 12-00294 | Kansas |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | 000747 | Missouri |
Profile Details
| NPI number | 1912933474 |
|---|---|
| LBN Legal business name | Theoharidis, Akilis Mike |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2006 |
| Last updated | Dec 23rd, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912933474 | NPPES |
| Missouri | MEDICAID | 308471408 | |
| Missouri | Other | 480031700 | |
| Missouri | MEDICAID | 308471432 | |
| Missouri | Other | 23501026 | |
| Missouri | Other | 480031697 |
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