Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1457374241 |
---|---|
Provider Name | Mr. David Kim Sager |
First Address | Saint Louis, MO 63125-4108 |
Second Address | Saint Louis, MO 63125-4108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 05/04/2010 |