Basic Information
| Provider Information | |||||||||
| NPI: | 1639462328 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAZAVIAN | ||||||||
| FirstName: | SHERVIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8717 W 110TH ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662102126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134282900 | ||||||||
| FaxNumber: | 9134282951 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 SE BLUE PKWY | ||||||||
| Address2: | |||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640631007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162825000 | ||||||||
| FaxNumber: | 9134282951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2011 | ||||||||
| LastUpdateDate: | 09/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 94-07633 | KS | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 2015013978 | MO | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.