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Individual

BENESTO F TUMANUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5844 NW BARRY RD, SUITE 340, KANSAS CITY, MO 64154-1465
(816) 880-6238
Mailing address
PO BOX 504538, SAINT LOUIS, MO 63150-4538
(816) 932-7940
(816) 932-7957

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
33929
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235100702
MO
05
203912605
MO
Enumeration date
01/31/2006
Last updated
03/30/2012
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