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General NPI Number Information
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NPI Number | 1073860532
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Entity Type | Individual
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Provider Name | DENISE RUSSELL TROWBRIDGE MD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 777 NW BLUE PKWY
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5799
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Country | US
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Telephone | 816-251-0578
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Fax |
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Provider Business Mailing Address
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Address Line | 777 NW BLUE PKWY
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5799
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Country | US
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Telephone | 816-251-0578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | R3P00
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License Number State | MO
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