Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 2014029494 | MO |
N | 207R00000X | Internist | MD14250 | HI |
N | 111NI0900X | Internist | MD14250 | HI |
N | 207R00000X | Internist | MDR-4844 | HI |
N | 111NI0900X | Internist | MDR-4844 | HI |
NPI | 1295711620 |
---|---|
Provider Name | Silvia Huebner |
First Address | Saint Louis, MO 63150-5164 |
Second Address | Springfield, MO 65807-7304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2005 |
Last Update Date | 26/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | MO |