Individual
DR. JOSEPH M MALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10101 STOLTZ DR, ROLLA, MO 65401-7714
(573) 364-0122
(573) 364-0129
Mailing address
10101 STOLTZ DR, ROLLA, MO 65401-7714
(573) 364-0122
(573) 364-0129
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MO2001027199
MO
207ND0101X
MOHS-Micrographic Surgery Physician
2001027199
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300281
UNITED HEALTHCARE PROVIDE
MO
01
—
138107
HEALTHLINK PROVIDER #
MO
01
—
152311
BLUE CROSS BLUE SHIELD
MO
05
—
205419906
—
MO
05
—
506121300
—
MO
Enumeration date
10/04/2006
Last updated
10/01/2020
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