Individual
MYO LWIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 HOSPITAL DR, COLUMBIA, MO 65201-5275
(573) 814-6000
Mailing address
800 HOSPITAL DR, COLUMBIA, MO 65201-5275
(573) 814-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2002020200
MO
Other
Enumeration date
03/21/2006
Last updated
07/08/2007
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