Individual
DR. BENJAMIN PETELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4321 WASHINGTON ST STE 3000, KANSAS CITY, MO 64111-5928
(816) 932-3100
(816) 932-6871
Mailing address
901 E. 104TH ST, MAILSTOP 400N, KANSAS CITY, MO 64131
(816) 502-7104
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0536409
KS
207R00000X
Internal Medicine Physician
Primary
2016028966
MO
Other
Enumeration date
06/24/2010
Last updated
01/29/2018
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