Individual
DR. STEPHANIE THEUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3270
(816) 983-6912
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3270
(816) 983-6912
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
5101012671
MI
2085P0229X
Pediatric Radiology Physician
0536143
KS
2085P0229X
Pediatric Radiology Physician
Primary
2012040468
MO
Other
Enumeration date
01/11/2007
Last updated
01/04/2013
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