Individual
MARIJA TONKOVIC-CAPIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 E EVERGREEN ST, CAMERON, MO 64429-2400
(816) 649-3208
(816) 649-3204
Mailing address
1600 E EVERGREEN ST, CAMERON, MO 64429-2400
(816) 649-3208
Taxonomy
Speciality
Code
Description
License number
State
193200000X
Multi-Specialty Group
Primary
2011006615
MO
193200000X
Multi-Specialty Group
94-06648
KS
207N00000X
Dermatology Physician
2011006615
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275731010
—
MO
Enumeration date
07/03/2007
Last updated
05/31/2016
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