Healthcare Provider Details

I. General information

NPI: 1275113383
Provider Name (Legal Business Name): CYNTHIA CHWEYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 GLENN HENDREN DR
LIBERTY MO
64068-9600
US

IV. Provider business mailing address

2521 GLENN HENDREN DR STE 104
LIBERTY MO
64068-3388
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-1001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2026026314
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: