Individual
DR. REINALDO ERNESTO MIJARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 S BROADWAY ST, SUITE 730, WICHITA, KS 67202-4227
(316) 393-9933
Mailing address
7829 E ROCKHILL ST STE 307, WICHITA, KS 67206-3914
(316) 990-1295
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0425360
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100169960B
—
KS
01
—
1750490694
BLUE CROSS
KS
Enumeration date
08/30/2006
Last updated
05/08/2023
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