Individual
THELDA M KESTENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 RAINBOW BLVD, DEPT OF INTERNAL MEDICINE, KANSAS CITY, KS 66160
(913) 588-6000
Mailing address
3901 RAINBOW BLVD., MS 2025, KANSAS CITY, KS 66160
(913) 588-3840
(913) 588-8761
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
04-17264
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06856030
BCBS KC
MO
05
—
100195180A
—
KS
05
—
200982205
—
MS
01
—
626230
FIRSTGUARD
KS
Enumeration date
09/06/2006
Last updated
05/28/2014
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