Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G2340 | TX |
N | 207V00000X | Obstetrician & Gynecologist | R3H70 | MO |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G2340 | TX |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD-41562 | IA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | R3H70 | MO |
NPI | 1063419638 |
---|---|
Provider Name | Dr. Michael S Cardwell |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 18/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A12963 | (02) |