Organization
STEPHANIE M REVELS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE M REVELS MD (PHYSICIAN)
(913) 484-5052
Entity
Organization
Contact information
Practice address
8249 W 95 TH STREET, SUITE 108, OVERLAND PARK, KS 66212-3200
(913) 484-5052
Mailing address
8249 W 95TH ST, SUITE 108, OVERLAND PARK, KS 66212-3217
(913) 484-5052
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
0428042
KS
Other
Enumeration date
11/29/2010
Last updated
07/17/2012
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