Provider Demographics
NPI:1568465417
Name:SHIREMAN, THOMAS J (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:SHIREMAN
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 1:3800 S WHITNEY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6739
Mailing Address - Country:US
Mailing Address - Phone:816-478-4887
Mailing Address - Fax:
Practice Address - Street 1:8580 N GREEN HILLS RD STE A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1419
Practice Address - Country:US
Practice Address - Phone:816-478-4887
Practice Address - Fax:816-478-7222
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000157507207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205000805Medicaid
MO100013891Medicare PIN
MO418A516AMedicare PIN
MO205000805Medicaid