Organization
BOONSLICK MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B CUSWORTH MD (PRESIDENT, BOONSLICK MED. GROUP INC)
(636) 947-3392
Entity
Organization
Contact information
Practice address
1301 BOONES LICK RD, SAINT CHARLES, MO 63301-2463
(636) 916-8228
(636) 946-5774
Mailing address
1301 BOONES LICK RD, SAINT CHARLES, MO 63301-2463
(636) 916-8228
(636) 946-5774
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
MO
Other
Enumeration date
12/18/2006
Last updated
07/21/2022
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