Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 30252 | MO |
N | 207RH0003X | Hematology & Oncology | DR-52800 | CO |
N | 207RH0003X | Hematology & Oncology | MD.05111R | LA |
NPI | 1073561536 |
---|---|
Provider Name | Dr. Carl G Kardinal |
First Address | Columbia, MO 65205-7687 |
Second Address | Columbia, MO 65203-3244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 25/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1305481 | (05) | LA |
B61613 | (02) |