MEDICARE: CLIFFORD S DEPEW 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	207V00000X	Obstetrics & Gynecology Physician	0422000	KS

General Provider Information

NPI Number	:	1114038544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD S DEPEW MD

Provider Business Mailing Address
First Line	:	3232 E MURDOCK
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-3003
Country	:	US
Telephone Number	:	316-685-7234
Fax Number	:	316-685-0317

Provider Business Practice Location Address
First Line	:	3232 E MURDOCK
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-3003
Country	:	US
Telephone Number	:	316-685-7234
Fax Number	:	316-685-0317

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/04/2009

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Directions to “ CLIFFORD S DEPEW MD” Practice Location

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