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Individual

DR. STEPHANIE A IKEME

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
7527 STATE AVE, KANSAS CITY, KS 66112-2815
(913) 335-6986
(855) 446-7151
Mailing address
PO BOX 616788, ORLANDO, FL 32861-6788
(407) 447-7120
(407) 770-0661

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-41757
KS
207Q00000X
Family Medicine Physician
2016015924
MO
207Q00000X
Family Medicine Physician
OS015504
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KA5102009
MEDICARE
KS
01
MA8204011
MEDICARE
MO
Enumeration date
12/17/2008
Last updated
11/29/2021
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