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Individual

MARIYA KOCHUBEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3800 S NATIONAL AVE STE 600, SPRINGFIELD, MO 65807-5249
(000) 000-0000
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2024008978
MO
208600000X
Surgery Physician
82145-20
WI
2086S0127X
Trauma Surgery Physician
82145-20
WI

Other

Enumeration date
04/04/2018
Last updated
10/04/2024
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