Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2005026617 | MO |
NPI | 1033175492 |
---|---|
Provider Name | Sascha Schubert |
First Address | Kansas City, MO 64108-2634 |
Second Address | Kansas City, MO 64108-2640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I44793 | (02) | MO |