Individual
DR. STEPHEN M MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4419 S CRYSLER AVE, INDEPENDENCE, MO 64055-5906
(816) 356-0400
(816) 356-0477
Mailing address
4419 S CRYSLER AVE, INDEPENDENCE, MO 64055-5906
(816) 356-0400
(816) 356-0477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R50258
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01240028
BLUE CROSS BLUE SHIELD OF KANSAS CITY
MO
01
—
080019432
RAILROAD MEDICARE PALMETTO GBA
MO
05
—
240286708
—
MO
Enumeration date
06/15/2005
Last updated
05/15/2008
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