Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2003024392 | MO |
Y | 208600000X | Surgeon | 2003024392 | MO |
NPI | 1003910225 |
---|---|
Provider Name | Eddy C Hsueh |
First Address | St. Louis, MO 63110 |
Second Address | Saint Louis, MO 63110-2539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 02/02/2021 |