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Individual

GEORGIA NOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3217 S PROVIDENCE RD, COLUMBIA, MO 65203-3639
(573) 884-7733
(573) 884-5559
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MDR3559
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200467207
MO
01
80043925
RR MEDICARE
MO
Enumeration date
05/27/2006
Last updated
09/29/2008
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