Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | R5C68 | MO |
NPI | 1285618876 |
---|---|
Provider Name | Dr. Marlys E Schuh |
First Address | Ballwin, MO 63011-2490 |
Second Address | Ballwin, MO 63011-2490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 15/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202405023 | (05) | MO |
A10511 | (02) | MO |