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Individual

DAVID DUETHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-2047
Mailing address
PO BOX 78009, SAINT LOUIS, MO 63178-8009
(866) 898-7142
(616) 975-9824

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2005005831
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35366013
BCBS
01
P00252271
RAILROAD MEDICARE
Enumeration date
08/17/2006
Last updated
12/17/2007
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