Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 2006020250 | MO |
N | 2086S0120X | Pediatric Surgery | 2006020250 | MO |
N | 2086S0122X | Plastic and Reconstructive Surgery | 2006020250 | MO |
N | 2086S0127X | Trauma Surgeon | 2006020250 | MO |
NPI | 1366460339 |
---|---|
Provider Name | Dr. Albert S Woo |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 28/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
959130543 | (05) | MO |