Provider Demographics
NPI:1891992228
Name:PIONTEK, ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:PIONTEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19001 E 48TH ST S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6964
Mailing Address - Country:US
Mailing Address - Phone:816-836-8831
Mailing Address - Fax:816-795-0144
Practice Address - Street 1:19001 E 48TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6964
Practice Address - Country:US
Practice Address - Phone:816-836-8831
Practice Address - Fax:816-795-0144
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013017453208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1891992228Medicaid
MOMA4068012Medicare UPIN