Provider Demographics
NPI:1346878493
Name:ANWANDER, ANNETTE K (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:K
Last Name:ANWANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:T
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7900 LEES SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64139-1246
Mailing Address - Country:US
Mailing Address - Phone:816-404-9597
Mailing Address - Fax:816-404-7756
Practice Address - Street 1:7900 LEES SUMMIT RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64139-1246
Practice Address - Country:US
Practice Address - Phone:816-404-9597
Practice Address - Fax:816-404-7756
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-49243207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine