Individual
RENU DEBROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
205 NW R D MIZE RD, SUITE 408, BLUE SPRINGS, MO 64014-2518
(816) 220-9942
(816) 220-9952
Mailing address
205 NW R D MIZE RD, SUITE 408, BLUE SPRINGS, MO 64014-2518
(816) 220-9942
(816) 220-9952
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
04-31297
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2005018218
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104845
BC/BS OF KS
—
01
—
357011
BC/BS OF KC
—
01
—
481225035
UNITED HEALTHCARE
—
01
—
7450751
AETNA
—
01
—
P00239678
RAILROAD RETIREMENT
—
Enumeration date
05/10/2006
Last updated
07/03/2008
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