Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 114445 | MO |
NPI | 1275639569 |
---|---|
Provider Name | Dr. Maria A Coffman |
First Address | Columbia, MO 65203 |
Second Address | Columbia, MO 65203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 26/09/2011 |