Individual
BRIAN STEPHAN PALLOHUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
(417) 820-8852
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2010003850
MO
207L00000X
Anesthesiology Physician
49827
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477671212
—
MO
05
—
413613000
—
MN
Enumeration date
03/27/2007
Last updated
05/22/2013
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