Blue River Medical Group, LLC

NPI #1770649022 in Independence, Missouri

Provider Information

NPI Number: 1770649022
Entity Type: Organization
Organization Name: Blue River Medical Group, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Dec 29, 2006
Last Updated: Oct 10, 2008

Practice Location

Address: 4911 S ARROWHEAD DR
Address 2: SUITE 101
City: Independence
State: Missouri
ZIP Code: 64055-7005
Phone: (816) 373-3006

Authorized Official

Name: DR. DEAN MUNDHENKE, M.D.
Title: PRESIDENT
Phone: (816) 373-3006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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