Provider Demographics
NPI:1447453394
Name:MEIROSE, STEPHEN ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:MEIROSE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:20500 BEE CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-9369
Mailing Address - Country:US
Mailing Address - Phone:816-858-4443
Mailing Address - Fax:816-858-4443
Practice Address - Street 1:2100 BAPTISTE DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1314
Practice Address - Country:US
Practice Address - Phone:913-294-2327
Practice Address - Fax:913-294-9897
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-26491207P00000X
MO101508207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG05547Medicare UPIN
KS041258Medicare ID - Type Unspecified