Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 105584 | MO |
NPI | 1053372334 |
---|---|
Provider Name | Akgun Ince |
First Address | Saint Louis, MO 63141-6857 |
Second Address | Saint Louis, MO 63141-6857 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 16/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114376 | BLUE CROSS BLUE SHIELD (01) | MO |
203962410 | (05) | MO |
3200034 | UNITED HEALTH CARE (01) | MO |
393877 | HEALTHLINK (01) | MO |
5098643 | AETNA (01) | MO |
G89561 | (02) | MO |
G89561 | CIGNA (01) | MO |
G89561 | GREAT WEST (01) | MO |
G89561 | MERCY (01) | MO |
G89561 | PHCS (01) | MO |