Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | R7H71 | MO |
NPI | 1689773541 |
---|---|
Provider Name | Dr. Robert Kocur |
First Address | Saint Louis, MO 63141-8705 |
Second Address | Saint Louis, MO 63141-8705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E65810 | (02) | MO |