Healthcare Provider Details

I. General information

NPI: 1063875227
Provider Name (Legal Business Name): MICHAEL JOHN LUNSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N RIVERSIDE RD STE 200
SAINT JOSEPH MO
64507-2566
US

IV. Provider business mailing address

5301 FARAON ST STE 120
SAINT JOSEPH MO
64506-3512
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-1301
  • Fax: 816-271-1302
Mailing address:
  • Phone: 816-271-1301
  • Fax: 816-271-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2022031957
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: