Individual
REGINA M. AHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 NE SAINT LUKES BLVD, SUITE 200, LEES SUMMIT, MO 64086-6003
(816) 347-5100
(816) 347-5136
Mailing address
20 NE SAINT LUKES BLVD STE 200, LEES SUMMIT, MO 64086-6001
(816) 347-5100
(816) 347-5136
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004023903
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207308701
—
MO
Enumeration date
07/09/2006
Last updated
06/04/2019
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