Individual
DAVID EUGENE FELLOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2100 SE BLUE PKWY, LEES SUMMIT, MO 64063-1007
(816) 282-5000
Mailing address
2537 MOMENTUM PL, EMERGENCY DEPARTMENT, CHICAGO, IL 60689-5325
(913) 205-8995
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001321
IN
363AS0400X
Surgical Physician Assistant
0894
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000740513
ANTHEM
IN
05
—
200572850B
—
KS
Enumeration date
05/18/2006
Last updated
09/10/2025
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