Basic Information
| Provider Information | |||||||||
| NPI: | 1376663724 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERAUD | ||||||||
| FirstName: | DOMINIC | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4320 BELLEVIEW AVE APT 201 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167561444 | ||||||||
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| Practice Location | |||||||||
| Address1: | ANESTHESIOLOGY DEPT, MSTP 1034 | ||||||||
| Address2: | KANSAS UNIV MED CENTER, 3901 RAINBOW BLVD | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 94-06610 TEMPORARY | KS | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.