Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | R5270 | MO |
NPI | 1669540928 |
---|---|
Provider Name | Dr. Daniel Paul Windsor |
First Address | Fenton, MO 63026-3474 |
Second Address | Fenton, MO 63026-3474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2006 |
Last Update Date | 08/07/2007 |