Individual
PULCHERIE GUISSOU ADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
404 N KEENE ST, COLUMBIA, MO 65201-6626
(573) 882-4438
Mailing address
400 N KEENE ST, COLUMBIA, MO 65201-6626
(573) 882-4438
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2023049015
MO
208000000X
Pediatrics Physician
2023049015
MO
208M00000X
Hospitalist Physician
Primary
01092542A
IN
Other
Enumeration date
10/02/2020
Last updated
03/02/2025
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