Provider Demographics
NPI:1558654392
Name:DEMPEWOLF, MICHAEL J (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:DEMPEWOLF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2861 NE INDEPENDENCE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2379
Mailing Address - Country:US
Mailing Address - Phone:816-525-2840
Mailing Address - Fax:816-525-2841
Practice Address - Street 1:4940B W. 137TH ST.
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224
Practice Address - Country:US
Practice Address - Phone:913-232-9846
Practice Address - Fax:913-232-9817
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS05-38785207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery