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Individual

DR. MOSES TABE AMBILICHU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3600 INTERSTATE 70 DR SE STE C, COLUMBIA, MO 65201-6583
(888) 410-5230
Mailing address
PO BOX 716, COLUMBIA, MO 65205-0716
(888) 595-5101

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
04-39077
KS
2084P0800X
Psychiatry Physician
Primary
2011019835
MO
2084P0800X
Psychiatry Physician
94029
GA
2084P0800X
Psychiatry Physician
IMLC.MD.61663049
WA
2084P0800X
Psychiatry Physician
U0278
TX

Other

Enumeration date
06/20/2008
Last updated
04/24/2026
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