Organization
GASTROENTEROLOGY ASSOCIATES OF SOUTHEAST MO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN CROCETTI (ADMINISTRATOR)
(573) 334-8870
Entity
Organization
Contact information
Practice address
1429 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 334-8870
(573) 334-7340
Mailing address
1429 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(573) 334-8870
(573) 334-7340
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502633506
—
MO
Enumeration date
05/28/2006
Last updated
06/09/2008
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