Individual
P A GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2516 PALOMINO DR, CAPE GIRARDEAU, MO 63701-1894
(573) 332-1829
Mailing address
2516 PALOMINO DR, CAPE GIRARDEAU, MO 63701-1894
(573) 332-1829
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2013002188
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201239407
—
MO
01
—
7932
BCBS
—
Enumeration date
10/17/2005
Last updated
02/02/2015
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