Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 2002002467 | MO |
NPI | 1003853763 |
---|---|
Provider Name | Michelle L Dew |
First Address | Kansas City, MO 64131 |
Second Address | Kansas City, MO 64111-5939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 01/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I50550 | (02) |