Provider Demographics
NPI:1548261860
Name:DUCHENE, DAVID A (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:DUCHENE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-7564
Mailing Address - Fax:913-588-7625
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:DEPARTMENT OF UROLOGY, MAIL STOP 3016
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-7564
Practice Address - Fax:913-588-7625
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008025048208800000X
KS04-31784208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36736012OtherBCBS KANSAS CITY
KS200374960AMedicaid
IA0458406Medicaid
IAI14807Medicare ID - Type Unspecified
KS200374960AMedicaid
IA0458406Medicaid