Individual
MICHAEL K. DEIPARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2521 GLENN HENDREN DR, SUITE 112, LIBERTY, MO 64068-3388
(816) 781-5006
Mailing address
7904 RAINES RD, LIBERTY, MO 64068-8585
(816) 415-0450
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
108296
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208014100
—
MO
Enumeration date
01/30/2007
Last updated
06/24/2011
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