Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 2002015736 | MO |
NPI | 1285689687 |
---|---|
Provider Name | Sara E Crowder |
First Address | Columbia, MO 65201-8023 |
Second Address | Columbia, MO 65201-8023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 29/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205887904 | (05) | MO |
H01062 | (02) |