Individual
DR. JOSEPH E MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R3L06
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16236011
BLUE CROSS BLUE SHIELD KC
—
05
—
206905903
—
MO
Enumeration date
08/19/2006
Last updated
11/02/2015
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