Individual
DR. STEPHEN ANTHONY FUSELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 N PROVIDENCE RD, COLUMBIA, MO 65203-4355
(573) 234-1070
Mailing address
4810 CLARK LN APT 102, COLUMBIA, MO 65202-9970
(256) 453-5056
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
2020009917
MO
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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