Individual
DR. MICHAEL R CRIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
814 FAIRLANE DR, BROOKFIELD, MO 64628-2318
(660) 258-3397
(660) 258-3945
Mailing address
814 FAIRLANE DR, BROOKFIELD, MO 64628-2318
(660) 258-3397
(660) 258-3945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4A27
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010066246
RAILROAD MEDICARE
MO
01
—
108161
HEALTHLINK
MO
01
—
111986
BLUE CROSS BLUE SHIELD MO
MO
01
—
1663
HEALTHCARE USA
MO
05
—
241186600
—
MO
Enumeration date
01/19/2006
Last updated
07/14/2017
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