Provider Demographics
NPI:1548284623
Name:CULLEN, ROBERT DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DANIEL
Last Name:CULLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1614
Mailing Address - Country:US
Mailing Address - Phone:816-478-4200
Mailing Address - Fax:816-875-2598
Practice Address - Street 1:3100 BROADWAY BLVD STE 509
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2413
Practice Address - Country:US
Practice Address - Phone:816-531-7373
Practice Address - Fax:816-531-1404
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0431872207YX0901X
CAA90092207YX0901X
MO2006015215207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSX84F404Medicare PIN