PREMA FANCY D SOUZA

INDEPENDENCE, MO
NPI1225417397
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: MO  2018028464)
Enumeration Date2015-05-22
Last Update Date2018-08-21
Business Address
PREMA FANCY D SOUZA MD
20300 E VALLEY VIEW PKWY
INDEPENDENCE, MO 64057
Phone number: 816-478-5200
Mailing Address
PREMA FANCY D SOUZA MD
2401 GILLHAM RD PROVIDER ENROLLMENT
KANSAS CITY, MO 64108-4619
Phone number: 816-701-5200