Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 2013032975 | MO |
Y | 111NI0900X | Internist | 2013032975 | MO |
N | 207R00000X | Internist | 48963 | TN |
N | 111NI0900X | Internist | 48963 | TN |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2013032975 | MO |
NPI | 1023045655 |
---|---|
Provider Name | Dr. Peter Scott Emerson |
First Address | Saint Louis, MO 63141-5047 |
Second Address | Richmond Heights, MO 63117-1811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 11/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023045655 | (05) | NC |
1023045655 | (05) | VA |
1530416 | (05) | TN |
7100238660 | (05) | KY |