Provider Demographics
NPI:1922192848
Name:KANZA MULTISPECIALTY GROUP PA
Entity type:Organization
Organization Name:KANZA MULTISPECIALTY GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:DADKHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-299-0089
Mailing Address - Street 1:1428 S 32ND ST
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66106-2106
Mailing Address - Country:US
Mailing Address - Phone:913-299-0089
Mailing Address - Fax:913-299-0873
Practice Address - Street 1:1428 S 32ND ST
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-2106
Practice Address - Country:US
Practice Address - Phone:913-299-0089
Practice Address - Fax:913-299-0873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty