Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 2019015447 | MO |
NPI | 1992361158 |
---|---|
Provider Name | Dr. Joshua Douglas Majerus |
First Address | Olivette, MO 63132-3130 |
Second Address | Olivette, MO 63132-3130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2019 |
Last Update Date | 14/05/2019 |