Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 100559 | MO |
NPI | 1215920541 |
---|---|
Provider Name | Dr. Dan L Pierce |
First Address | Columbia, MO 65201-8023 |
Second Address | Columbia, MO 65201-8023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E48769 | (02) | MO |