Provider Demographics
NPI:1205808672
Name:PLUENNEKE, ROBERT E (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:PLUENNEKE
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 1:9200 INDIAN CREEK PKWY
Mailing Address - Street 2:BUILDING 9, SUITE 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2002
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:8700 NORTH GREEN HILLS RD.
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1493
Practice Address - Country:US
Practice Address - Phone:913-574-2520
Practice Address - Fax:913-574-2612
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO110145207RH0003X
KS04-23691207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1205808672Medicaid
KS100149870EMedicaid
KS100149870DMedicaid
KSK40000180Medicare PIN
KS100149870EMedicaid
MO1205808672Medicaid
MOP00975487Medicare PIN