Provider Demographics
NPI:1891732137
Name:STEBBINS, DANIELLE R (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:R
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:7405 RENNER RD
Practice Address - Street 2:KU MEDWEST
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9414
Practice Address - Country:US
Practice Address - Phone:913-588-8400
Practice Address - Fax:913-588-8413
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-30754207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
33947034OtherBCBS PROVIDER NUMBER
481159444OtherJAYHAWK TAX ID
7126577OtherAETNA
157695XXOtherPREFERRED CARE OF NY
481940OtherFIRSTGUARD
10001706701OtherCHP PROVIDER NUMBER
KS200262100CMedicaid
P00240408OtherRR MEDICARE
KSJ61D011AMedicare PIN
481159444OtherJAYHAWK TAX ID