Individual
DR. JUANITO MAQUILAN MELENDRES I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6447
Mailing address
7400 GLEASON RD, SHAWNEE, KS 66227-2226
(913) 422-0778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14530
KS
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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