Individual
DR. JULIE GRACE KOSTREVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
04-50068
KS
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
2018022087
MO
Other
Enumeration date
03/27/2018
Last updated
03/01/2026
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