Individual
DR. BLAKE E. WENDELBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 632-2230
(913) 632-2297
Mailing address
PO BOX 411895, KANSAS CITY, MO 64141-1895
(913) 632-2230
(913) 632-2297
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
04-27802
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050061472
RAILROAD
KS
05
—
100327480B
—
KS
05
—
203882212
—
MO
01
—
25712015
BCBS KC
KS
Enumeration date
02/28/2006
Last updated
11/30/2020
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