Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2017016925 | MO |
N | 208600000X | Surgeon | 2017016925 | MO |
Y | 2086S0120X | Pediatric Surgery | 2017016925 | MO |
NPI | 1255499646 |
---|---|
Provider Name | Ashwin Prafulla Pimpalwar |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65201-6626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 26/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
207523408 | (05) | MO |
782345 | HEALTHLINK (01) | MO |
I68944 | (02) | MO |