Individual
ANDREA M VANDEVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2007016087
MO
2080C0008X
Child Abuse Pediatrics Physician
2007016087
MO
208VP0000X
Pain Medicine Physician
2007016087
MO
Other
Enumeration date
05/31/2007
Last updated
04/01/2016
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