Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | MO6340 | MO |
NPI | 1922203330 |
---|---|
Provider Name | Dr. Dana E. Alter |
First Address | Manchester, MO 63021-5495 |
Second Address | Manchester, MO 63021-5495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 02/06/2014 |