Individual
MICHAEL WAYNE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 N KEENE ST STE 400, COLUMBIA, MO 65201-8104
(573) 817-3097
Mailing address
4810 CENTER BROOK CT, COLUMBIA, MO 65203-9196
(573) 355-5141
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
112910
MO
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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