| Blue River Medical Group, Llc | |
|
4911 S Arrowhead Dr Suite 101 Independence MO 64055-7005 | |
| (816) 373-3006 | |
| (816) 373-3087 |
| Full Name | Blue River Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4911 S Arrowhead Dr, Independence, Missouri |
| Authorized Official Name and Position | Dean Mundhenke (PRESIDENT) |
| Authorized Official Contact | 8163733006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue River Medical Group, Llc 4911 S Arrowhead Dr Suite 101 Independence MO 64055-7005 Ph: (816) 373-3006 | Blue River Medical Group, Llc 4911 S Arrowhead Dr Suite 101 Independence MO 64055-7005 Ph: (816) 373-3006 |
| NPI Number | 1770649022 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 10/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770649022 | NPI | - | NPPES |
| 151111 | Other | MO | AETNA |
| 32939018 | Other | MO | BLUE CROSS BLUE SHIELD |
| 168067 | Other | MO | COVENTRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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