Individual
MATILDA DERVISEVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2024024774
MO
208000000X
Pediatrics Physician
94-11874
KS
Other
Enumeration date
03/19/2024
Last updated
08/26/2024
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