Individual
SUSAN L PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
305 N KEENE ST, COLUMBIA, MO 65201-6897
(573) 882-8000
(573) 882-6600
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD106477
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208879205
—
MO
01
—
80114334
RR MEDICARE
MO
Enumeration date
05/24/2006
Last updated
04/10/2009
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