Individual
DR. MATTHEW A KIENSTRA
Active
Individual
DR. MATTHEW A KIENSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
2006003278
MO
207YS0123X
Facial Plastic Surgery Physician
Primary
2006003278
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160592001
—
AR
05
—
200586204
—
MO
01
—
204558
MO BLUE SHIELD
MO
01
—
83878
ARK BLUE SHIELD
AR
Enumeration date
02/06/2007
Last updated
05/06/2024
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