Dr. Crisanto Gualberto
General Practice Physician
106 W State Street
Vandalia
, Missouri 63382
Dr. Crisanto Gualberto
General Practice Physician
106 W State Street
Vandalia
, Missouri 63382
(573) 594-6208
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Crisanto Gualberto
- 106 W State Street
- Vandalia, MO
- Zip : 63382-1239
- Phone : (573) 594-6208
Second Address
- Dr. Crisanto Gualberto
- 106 W State Street
- Vandalia, MO
- Zip : 63382
- Fax : (573) 594-6780
- Phone : (573) 594-6208
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | R6651 | MO |
National Provider Identifier
| NPI | 1043285398 |
|---|---|
| Provider Name | Dr. Crisanto Gualberto |
| First Address | Vandalia, MO 63382-1239 |
| Second Address | Vandalia, MO 63382 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2006 |
| Last Update Date | 06/12/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| A11087 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.