Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2012003519 | MO |
N | 208600000X | Surgeon | 2012003519 | MO |
N | 2086S0102X | Surgical Critical Care | 2012003519 | MO |
Y | 2086S0120X | Pediatric Surgery | 2012003519 | MO |
NPI | 1326364654 |
---|---|
Provider Name | Dr. Adam Mark Vogel |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 23/10/2015 |