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Individual
MR. KEVIN A NETTESHEIM
Active
Individual
MR. KEVIN A NETTESHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000531
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104946-003
BLUE CROSS/BLUE SHIELD
MO
01
—
107843
HEALTHLINK
MO
05
—
308054006
—
MO
01
—
4443980001
DMERC/CIGNA
MO
01
—
480033520
RAILROAD MEDICARE
MO
Enumeration date
05/23/2005
Last updated
04/28/2015
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