Provider Demographics
NPI:1821067422
Name:KUNZ, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:KUNZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10205 CATALINA ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19609 E 9TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64056-3088
Practice Address - Country:US
Practice Address - Phone:816-796-1412
Practice Address - Fax:816-796-3398
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR65782085R0202X, 2085B0100X
KS04-280262085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00237690OtherRR MEDICARE
MOP00152855OtherRR MEDICARE
MOP00152855OtherRR MEDICARE
KSP00237690Medicare PIN
KSK674592AMedicare PIN
MO0564592AMedicare PIN
KSP00237690OtherRR MEDICARE
MOC50820Medicare UPIN
MOP00152855Medicare PIN