Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 2017012852 | MO |
NPI | 1235659061 |
---|---|
Provider Name | Dr. Colin William Mcinnes |
First Address | Saint Louis, MO 63110 |
Second Address | Saint Louis, MO 63110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2017 |
Last Update Date | 02/01/2018 |