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NPI Code Detail

MEDICARE: DR. ROBERT B STURDEVANT D.O

MEDICARE: DR. ROBERT B STURDEVANT D.O
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
1208000000XPediatrics Physician105957MO
2208000000XPediatrics Physician05-26244KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215934039
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT B STURDEVANT D.O
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 181-623-4300
Fax Number :
Provider Business Practice Location Address
First Line : 501 NW BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-2732
Country : US
Telephone Number : 181-641-3250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/31/2014

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