Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2007021701 | MO |
N | 208000000X | Pediatrician | IL |
NPI | 1033296801 |
---|---|
Provider Name | Steve Warren Handoyo |
First Address | Kansas City, MO 64111-3406 |
Second Address | Kansas City, MO 64108-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/01/2008 |