Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | R7A67 | MO |
NPI | 1114950870 |
---|---|
Provider Name | William Sprich |
First Address | Saint Louis, MO 63127-1019 |
Second Address | Saint Louis, MO 63117-1818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 28/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208766006 | (05) | MO |
C44508 | (02) |