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
Fax: (816) 356-0477
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225033459 NPPES
Missouri MEDICAID 240286708
Missouri Other 01240028
Missouri Other 080019432

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