Provider Demographics
NPI:1316917107
Name:FINKELSTON, MARK S (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:FINKELSTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 W 75TH ST
Mailing Address - Street 2:STE. 320
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2205
Mailing Address - Country:US
Mailing Address - Phone:913-362-2229
Mailing Address - Fax:913-362-0460
Practice Address - Street 1:8800 W 75TH ST
Practice Address - Street 2:STE. 320
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2205
Practice Address - Country:US
Practice Address - Phone:913-362-2229
Practice Address - Fax:913-362-0460
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0521006207VG0400X
KS05-21006174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSA22000011OtherMEDICARE
KS100234670AMedicaid
KS100234670AMedicaid