Individual
MATTHEW NEALY FANDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6250
Mailing address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0065194
CO
Other
Enumeration date
02/24/2006
Last updated
04/10/2023
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