Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 101868 | MO |
NPI | 1063452787 |
---|---|
Provider Name | Dr. Pierre Moeser |
First Address | Saint Louis, MO 63141-8573 |
Second Address | Saint Peters, MO 63376-1622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 06/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A64466 | (02) | MO |