Individual
DR. ROBYN MARIE MCCULLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1241 WEST STADIUM BLVD, JEFFERSON CITY, MO 65109
(573) 556-7719
(573) 635-2156
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110
(573) 635-5264
(573) 635-2156
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME94433
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598749467
—
MO
01
—
CP9089
RAILROAD GROUP
MO
01
—
P00635931
MEDICARE RAILROAD
MO
Enumeration date
12/02/2005
Last updated
06/28/2023
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