Individual
DR. DAVID P HALBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12317 WENONGA LN, LEAWOOD, KS 66209-1436
(913) 400-3511
Mailing address
12317 WENONGA LN, LEAWOOD, KS 66209-1436
(913) 400-3511
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2004034264
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001784000
COMMUNITY HEALTH PLAN
—
05
—
200317660A
—
KS
05
—
209457506
—
MO
01
—
35021014
BLUE CROSS BLUE SHIELD KC
—
Enumeration date
06/24/2006
Last updated
03/16/2011
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