Organization
SUMMIT GASTROENTEROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY ASTEL WALLER APRN BC (OFFICE MANAGER NURSE PRACTITIONER)
(816) 554-3838
Entity
Organization
Contact information
Practice address
20 NE SAINT LUKES BLVD, SUITE #330, LEES SUMMIT, MO 64086
(816) 554-3838
(816) 554-1634
Mailing address
20 NE SAINT LUKES BLVD, SUITE #330, LEES SUMMIT, MO 64086
(816) 554-3838
(816) 554-1634
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507580405
—
MO
Enumeration date
07/13/2006
Last updated
05/07/2008
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