Individual
MICHELLE Y CEBULKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
805 N 36TH ST STE B, SAINT JOSEPH, MO 64506-2954
(816) 396-6026
(816) 398-6896
Mailing address
805 N 36TH ST STE B, SAINT JOSEPH, MO 64506-2954
(816) 396-6026
(816) 398-6896
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
112854
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100369520A
—
KS
05
—
205008006
—
MO
Enumeration date
12/11/2006
Last updated
09/25/2020
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