Individual
MARC DEVRIES LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111
(816) 932-2047
Mailing address
PO BOX 78009, ST LOUIS, MO 63178
(616) 975-9824
(616) 975-9827
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
2006010971
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37548019
BCBS
—
01
—
P00393448
RAILROAD MEDICARE
—
Enumeration date
07/31/2006
Last updated
03/03/2008
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