MEDICARE: DR. MARK H DEWOLFE M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	R3A25	MO
2	207RH0003X	Hematology & Oncology Physician	04-19790	KS

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
13	97759	OTHER	MO	ADVANTRA MEDICARE REPLACE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13192	OTHER	MO	COVENTRY
2	4340992	OTHER	MO	AETNA
3	12440	OTHER	MO	HM CARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	026295099	OTHER	MO	FEDERAL BLACK LUNG
7	09468014	OTHER	MO	BCBS OF KANSAS CITY
8	1001457701	OTHER	MO	COMMUNITY HEALTH PLAN
9	497815	OTHER	KS	BCBS OF KANSAS
10	560391	OTHER	MO	FIRSTGUARD
11	3650047	OTHER	MO	UHC
12	480911591028	OTHER	MO	CIGNA

NPI Number	:	1124021142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK H DEWOLFE M.D.

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4517
Country	:	US
Telephone Number	:	816-502-8752
Fax Number	:	816-932-9670

Provider Business Practice Location Address
First Line	:	5400 N OAK TRFY
Second Line	:	SUITE 101
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-4688
Country	:	US
Telephone Number	:	816-454-1658
Fax Number	:	816-454-1734

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/12/2026