Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 112376 | MO |
NPI | 1407869050 |
---|---|
Provider Name | Dr. Debra L Schaeffergrime |
First Address | Ballwin, MO 63021-8336 |
Second Address | Ballwin, MO 63021-8336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |