MEDICARE: DR. DAVID A DUCHENE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	2008025048	MO
2	208800000X	Urology Physician	04-31784	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36736012	OTHER	MO	BCBS KANSAS CITY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548261860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A DUCHENE MD

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	4070 DELP MAIL STOP 4017
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-7564
Fax Number	:	913-588-7625

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	DEPARTMENT OF UROLOGY, MAIL STOP 3016
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-7564
Fax Number	:	913-588-7625

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/17/2018

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