Provider Demographics
NPI:1548458672
Name:MIHORDIN, CARRIE A (DO)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:A
Last Name:MIHORDIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:A
Other - Last Name:HEINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:STE 209, MID-AMERICA RHEUMATOLOGY CONSULTANTS
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-661-9980
Mailing Address - Fax:913-661-9173
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:STE 209, MID-AMERICA RHEUMATOLOGY CONSULTANTS
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-661-9980
Practice Address - Fax:913-661-9173
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-35121207RR0500X
CT045544207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology