Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 05-39361 | KS |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2016025802 | MO |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 57130 | MN |
N | 208G00000X | Cardiothoracic Vascular Surgeon | DR.0058695 | CO |
NPI | 1043460710 |
---|---|
Provider Name | Dr. Justin Van Meeteren |
First Address | Kansas City, MO 64132-1152 |
Second Address | Kansas City, MO 64111-5941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 04/01/2022 |