Individual
DR. CRISANTO GUALBERTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 W STATE STREET, VANDALIA, MO 63382
(573) 594-6208
(573) 594-6780
Mailing address
106 W STATE STREET, VANDALIA, MO 63382-1239
(573) 594-6208
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
R6651
MO
Other
Enumeration date
02/21/2006
Last updated
12/06/2010
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