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Individual

DR. BRENTON RAVAL COGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1229 E SEMINOLE ST, SUITE 220, SPRINGFIELD, MO 65804-2227
(417) 820-5150
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4260

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2009027848
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427107283
MO
Enumeration date
01/10/2007
Last updated
11/01/2019
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