Individual
MATTHEW CIANCIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20 NE SAINT LUKES BLVD, STE. 200, LEES SUMMIT, MO 64086-6001
(813) 347-5100
(816) 347-5136
Mailing address
901 E. 104TH ST., MAILSTOP 400N, KANSAS CITY, MO 64131-9712
(816) 502-7104
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006004613
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053362681
—
MO
Enumeration date
05/16/2006
Last updated
02/22/2018
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