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Contact Information

SAM A DETWILER, MD, ATC
3901 RAINBOW BLVD # MS 2027
KANSAS CITY, KS66160-0006
 Phone: 913-588-3974
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for SAM A DETWILER · (Male)

NPI Number 1871025767
Status Active
Credentials MD, ATC
Entity Individual
Enumeration date 03/30/2017
Last updated 06/13/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • KS License # 94-11926
  • TX License # AT8023
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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