Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 2018013809 | MO |
NPI | 1154764116 |
---|---|
Provider Name | Dr. Schuyler Josef Halverson |
First Address | Saint Louis, MO 63141-8266 |
Second Address | Saint Louis, MO 63141-8266 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 29/10/2021 |