Mesa, Stephen M
Mesa, Stephen M is an sole proprietor health care provider with primary practice located at 4419 S Crysler Ave , Independence MO 64055-5906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mesa, Stephen M can be contacted via phone (816) 356-0400.Contact Information
Primary practice address
4419 S Crysler Ave
Independence MO 64055-5906
Phone: (816) 356-0400
Fax: (816) 356-0477
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R50258 | Missouri |
Profile Details
| NPI number | 1225033459 |
|---|---|
| LBN Legal business name | Mesa, Stephen M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2005 |
| Last updated | May 15th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225033459 | NPPES |
| Missouri | MEDICAID | 240286708 | |
| Missouri | Other | 01240028 | |
| Missouri | Other | 080019432 |
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