Individual
MIMOZA ISUFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 303-1661
(573) 884-4612
Mailing address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 303-1661
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2022024174
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022024174
MO BOARD OF HEALING ARTS
MO
Enumeration date
06/30/2022
Last updated
06/30/2022
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