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Individual

DR. STEPHANIE HOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 556-7719
(573) 635-2156
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 556-7719
(573) 635-2156

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
111174
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070013526
RAILROAD MEDICARE
MO
05
204713408
MO
01
CD6059
RR GROUP
MO
Enumeration date
01/19/2006
Last updated
05/28/2014
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