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Individual

DR. MARK R NEUSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
8675 COLLEGE BLVD STE 200, OVERLAND PARK, KS 66210
(913) 491-5501
(913) 491-8901
Mailing address
8675 COLLEGE BLVD STE 200, OVERLAND PARK, KS 66210
(913) 491-5501
(913) 491-8901

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
105826
MO
207K00000X
Allergy & Immunology Physician
Primary
25074
KS

Other

Enumeration date
06/26/2006
Last updated
07/08/2007
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