| Cedar Creek Medical Group Llc | |
|
100 Nw Mock Ave Blue Springs MO 64014-2501 | |
| (816) 463-6001 | |
| (816) 463-6004 |
| Full Name | Cedar Creek Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Nw Mock Ave, Blue Springs, Missouri |
| Authorized Official Name and Position | Patrick Kueny (VP) |
| Authorized Official Contact | 8164636001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Creek Medical Group Llc 100 Nw Mock Ave Blue Springs MO 64014-2500 Ph: (816) 463-6001 | Cedar Creek Medical Group Llc 100 Nw Mock Ave Blue Springs MO 64014-2501 Ph: (816) 463-6001 |
| NPI Number | 1699721951 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699721951 | NPI | - | NPPES |
| 200543790 A | Medicaid | KS | |
| 500672704 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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