Individual
MONIKA M PROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 636-9756
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
107116
MO
2085R0202X
Diagnostic Radiology Physician
Primary
107116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208700302
—
MO
Enumeration date
03/01/2006
Last updated
01/10/2023
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