Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 011423 | MO |
NPI | 1003929449 |
---|---|
Provider Name | Dr. James W Andrews |
First Address | Columbia, MO 65203-5661 |
Second Address | Columbia, MO 65203-5661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |