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1730172859

NPI Code Detail

MEDICARE: MS. HEIDI B KUTTENKULER D.O.

MEDICARE: MS. HEIDI B KUTTENKULER 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
1	207R00000X	Internal Medicine Physician	05-29948	KS
2	207R00000X	Internal Medicine Physician	2002029298	MO
3	208M00000X	Hospitalist Physician	05-29948	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	510610	OTHER		FIRST GUARD
2	32019016	OTHER		BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730172859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEIDI B KUTTENKULER D.O.

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	:	4401 WORNALL RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3220
Country	:	US
Telephone Number	:	816-932-0340
Fax Number	:	816-932-3148

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	01/16/2017

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Directions to “ MS. HEIDI B KUTTENKULER D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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