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Individual

MICHELLE R DUDZINSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9301 W 74TH ST, SUITE 130, SHAWNEE MISSION, KS 66204-2207
(913) 632-9130
(913) 632-9149
Mailing address
9301 W 74TH ST, SUITE 130, SHAWNEE MISSION, KS 66204-2207
(913) 632-9130
(913) 632-9149

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
100151
MO
207VX0201X
Gynecologic Oncology Physician
Primary
427545
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160056241
RAILROAD MEDICARE
01
18093039
BCBS OF KANSAS CITY
05
203448204
MO
01
33677
HEALTHCARE USA
01
4408217
AETNA
01
7400201
UHC
Enumeration date
05/25/2006
Last updated
05/19/2016
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