Individual
MARTIN TIBUAKUU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1605 E BROADWAY STE 300, COLUMBIA, MO 65201-8023
(573) 256-7700
(573) 256-3003
Mailing address
1605 E BROADWAY STE 300, COLUMBIA, MO 65201-8023
(573) 256-7700
(573) 256-3003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2023033163
MO
207RC0000X
Cardiovascular Disease Physician
Primary
2023033163
MO
208M00000X
Hospitalist Physician
2023033163
MO
Other
Enumeration date
06/12/2017
Last updated
02/21/2025
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