Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MO R9543 | MO |
NPI | 1053318535 |
---|---|
Provider Name | Dr. Robert M. Huster |
First Address | Liberty, MO 64068-7129 |
Second Address | Liberty, MO 64068-7129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 24/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A25207 | (02) | MO |