Provider Demographics
NPI:1265485403
Name:BLUESTEM MEDICAL, LLP
Entity Type:Organization
Organization Name:BLUESTEM MEDICAL, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MACHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-754-3333
Mailing Address - Street 1:501 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:QUINTER
Mailing Address - State:KS
Mailing Address - Zip Code:67752-9795
Mailing Address - Country:US
Mailing Address - Phone:785-754-3333
Mailing Address - Fax:785-754-2335
Practice Address - Street 1:501 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:QUINTER
Practice Address - State:KS
Practice Address - Zip Code:67752-9795
Practice Address - Country:US
Practice Address - Phone:785-754-3333
Practice Address - Fax:785-754-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110787OtherBCBS
KS110787OtherBCBS