Individual
DR. LISA G. DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12541 FOSTER ST STE 300, OVERLAND PARK, KS 66213-2304
(913) 317-3200
(913) 317-3218
Mailing address
12541 FOSTER ST STE 300, OVERLAND PARK, KS 66213-2304
(913) 317-3200
(913) 317-3218
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0450138
KS
207R00000X
Internal Medicine Physician
119536
MO
208000000X
Pediatrics Physician
119536
MO
Other
Enumeration date
06/09/2005
Last updated
11/12/2024
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