Individual
DR. DAVID C MENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6575
(816) 271-7644
Mailing address
PO BOX 8252, 3906 OAKLAND AVE., SAINT JOSEPH, MO 64508-8252
(816) 271-6575
(816) 271-7644
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
118572
MO
2085R0202X
Diagnostic Radiology Physician
Primary
118572
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100458610F
—
KS
05
—
1295784767
—
IA
01
—
1528169752
SECOND NPI NUMBER FOR MEDICARE GROUP # I23000A
MO
05
—
208408906
—
MO
01
—
P00382512
RAILROAD MEDICARE
MO
Enumeration date
05/10/2006
Last updated
06/29/2021
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