Provider Demographics
NPI:1073576302
Name:MASLAN, MARK JEFFREY (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:JEFFREY
Last Name:MASLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5520 COLLEGE BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1630
Mailing Address - Country:US
Mailing Address - Phone:913-663-5100
Mailing Address - Fax:913-663-3354
Practice Address - Street 1:5520 COLLEGE BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1630
Practice Address - Country:US
Practice Address - Phone:913-663-5100
Practice Address - Fax:913-663-3354
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2020-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-21348207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202403002Medicaid
KS2050277901Medicaid