Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2007011591 | MO |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2007011591 | MO |
NPI | 1851456990 |
---|---|
Provider Name | Ian M Rosbrugh |
First Address | North Kansas City, MO 64116-3276 |
Second Address | North Kansas City, MO 64116-3276 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 22/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1851456990 | (05) | MO |