Individual
JEENA VIJI EAPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10540 MARTY ST STE 100, OVERLAND PARK, KS 66212-2560
(913) 660-1616
(913) 660-0998
Mailing address
12101 WOODCREST EXECUTIVE DR STE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-39497
KS
207R00000X
Internal Medicine Physician
2017010742
MO
207R00000X
Internal Medicine Physician
231044
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023018926
—
MO
Enumeration date
07/21/2005
Last updated
10/20/2017
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