Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2012017477 | MO |
Y | 208600000X | Surgeon | 2012017477 | MO |
N | 2086S0102X | Surgical Critical Care | 2012017477 | MO |
NPI | 1134292808 |
---|---|
Provider Name | Dr. Robert D Winfield |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63108-1402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 27/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101740112 | (05) | MO |