Individual
DR. RUSTICO V SIMPELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
108 FRIZZELL ST, POTOSI, MO 63664-1505
(573) 438-5408
(573) 438-2419
Mailing address
300 HEALTHWAY, POTOSI, MO 63664-1420
(573) 438-5408
(573) 438-2419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
33913
MO
207Q00000X
Family Medicine Physician
Primary
33913
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597954205
—
MO
Enumeration date
11/30/2005
Last updated
07/20/2015
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