Provider Demographics
NPI:1194938118
Name:NEWLAND, MEGGAN R (MD)
Entity type:Individual
Prefix:DR
First Name:MEGGAN
Middle Name:R
Last Name:NEWLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGGAN
Other - Middle Name:R
Other - Last Name:BANTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-599-9499
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4400 BROADWAY BLVD STE 400
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3342
Practice Address - Country:US
Practice Address - Phone:816-932-4500
Practice Address - Fax:816-932-4635
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0432913207N00000X
MO2007021690207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1194938118Medicaid
MO1194938118Medicaid
KSW19A00002Medicare PIN