| |
400 N Main St Monroe City MO 63456-1318 | |
(573) 735-4541 | |
(573) 735-2143 |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 400 N Main St, Monroe City, Missouri |
Authorized Official Name and Position | Michael J Bukstein (PHYSICIAN EXEC DIRECTOR) |
Authorized Official Contact | 5732313172 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
100 Medical Dr Hannibal MO 63401-6877 Ph: (573) 221-5250 | 400 N Main St Monroe City MO 63456-1318 Ph: (573) 735-4541 |
NPI Number | 1447239157 |
---|---|
Provider Enumeration Date | 01/11/2006 |
Last Update Date | 04/18/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447239157 | NPI | - | NPPES |
000013771 | Other | MO | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |