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Individual

DR. WYLIE CRAIG DE VERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5501 NW 62ND TER STE 100, KANSAS CITY, MO 64151-2412
(816) 842-4440
(816) 842-1974
Mailing address
5501 NW 62ND TER STE 100, KANSAS CITY, MO 64151-2412
(816) 842-4440
(816) 842-1974

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2022026486
MO
207R00000X
Internal Medicine Physician
4301106085
MI

Other

Enumeration date
10/11/2007
Last updated
10/06/2022
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