Organization
GASTRO INTESTINAL CONSULTANTS OF MANHATTAN,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W TRAVIS DIERENFELDT MD (DOCTOR)
(785) 539-0156
Entity
Organization
Contact information
Practice address
1213 HYLTON HEIGHTS RD, SUITE 101, MANHATTAN, KS 66502-2810
(785) 539-0156
(785) 539-0177
Mailing address
1213 HYLTON HEIGHTS RD, SUITE 101, MANHATTAN, KS 66502-2810
(785) 539-0156
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-28673
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100014893
RAILROAD MEDICARE
KS
01
—
110814
BLUE CROSS BLUE SHIELD
KS
05
—
200347640A
—
KS
01
—
337060
FIRST GUARD
KS
Enumeration date
07/29/2006
Last updated
06/21/2018
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