Organization
CEDAR CREEK MEDICAL GROUP LLC
Active
Organization
CEDAR CREEK MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK KUENY (VP)
(816) 463-6001
Entity
Organization
Contact information
Practice address
100 NW MOCK AVE, BLUE SPRINGS, MO 64014-2501
(816) 463-6001
(816) 463-6004
Mailing address
100 NW MOCK AVE, BLUE SPRINGS, MO 64014-2500
(816) 463-6001
(816) 463-6004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200543790 A
—
KS
05
—
500672704
—
MO
Enumeration date
05/26/2006
Last updated
08/18/2008
Update your record
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