Individual
LAURA J. SIEVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1316 OLD HIGHWAY 63 S, SUITE 102, COLUMBIA, MO 65201-6092
(573) 815-8000
Mailing address
PO BOX 975, COLUMBIA, MO 65205-0975
(817) 570-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
108427
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203996210
—
MO
Enumeration date
10/04/2005
Last updated
06/26/2014
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