Individual
STEWART E DISMUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
2707 E 21ST ST N, WICHITA, KS 67214-2249
(316) 691-0249
(316) 691-9939
Mailing address
1010 N KANSAS ST, SUITE #3049, WICHITA, KS 67214-3124
(316) 293-2620
(316) 293-1882
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-23530
KS
2083P0901X
Public Health & General Preventive Medicine Physician
04-23530
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043285463
—
KS
Enumeration date
02/20/2006
Last updated
03/08/2012
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