Organization
LEE'S SUMMIT DERMATOLOGY ASSOCIATES I, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W MCEWEN M.D. (OWNER)
(816) 525-8500
Entity
Organization
Contact information
Practice address
276 NE TUDOR RD, LEE'S SUMMIT, MO 64086-5696
(816) 525-8500
(816) 525-0185
Mailing address
276 NE TUDOR RD, LEE'S SUMMIT, MO 64086-5696
(816) 525-8500
(816) 525-0185
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R9N60
MO
Other
Enumeration date
01/29/2007
Last updated
08/22/2008
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