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Individual

DR. MIRSAD DUPANOVIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-0001
(913) 588-3315
(913) 588-3365
Mailing address
PO BOX 411851, KANSAS CITY, MO 64141-1851
(913) 588-3315
(913) 588-3365

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-32817
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026573101
UNIVERA PROVIDER#
NY
01
000922097001
BD WNY/HEALTHNOW#
05
00372225
NY
05
02410415
NY
01
2222
BLUE SHIELD GROUP#
NY
01
7995442
AETNA PROVIDER#
01
G0189393590
BLUE CHOICE GROUP#
NY
01
MDH506
PREFERRED CARE#
01
P010226079
BLUE CHOICE PROVIDER#
Enumeration date
07/10/2006
Last updated
07/24/2014
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