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Individual

ALICIA CARYN BACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
404 N KEENE ST, COLUMBIA, MO 65201-6626
(573) 882-3961
(573) 884-4277
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943

Taxonomy

Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
2018009380
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200062622
MO
Enumeration date
05/01/2015
Last updated
08/16/2022
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