Provider Demographics
NPI:1386606572
Name:SACHEN, FRED L (MD)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:L
Last Name:SACHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 CLAY EDWARDS DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116
Mailing Address - Country:US
Mailing Address - Phone:816-472-5157
Mailing Address - Fax:816-472-7201
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 500
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-472-5157
Practice Address - Fax:816-472-7201
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8F152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202077715Medicaid
MO602984OtherCIGNA
MO105400026OtherBLUE SHIELD
MO0550031OtherUNITED HEALTH CARE
MO4303527OtherAETNA
MO202077723Medicaid
MO10001511701OtherCOMMUNITY HEALTH PLAN
MO202077715Medicaid
MO0550031OtherUNITED HEALTH CARE
MO8276404BMedicare ID - Type Unspecified
MO105400026OtherBLUE SHIELD