Individual
ETHAN CRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 884-9066
(573) 884-3037
Mailing address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 884-1606
(573) 884-5690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2016017341
MO
207W00000X
Ophthalmology Physician
Primary
2016017341
MO
Other
Enumeration date
06/20/2016
Last updated
05/28/2020
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