Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2014020908 | MO |
Y | 208600000X | Surgeon | 2014020908 | MO |
NPI | 1013322239 |
---|---|
Provider Name | Ioan-Andrei Scumpu |
First Address | Columbia, MO 65212-1000 |
Second Address | Columbia, MO 65212-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 26/06/2014 |