| NPI | 1588662803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B CUSWORTH President, Boonslick Med.Group Inc 636-916-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 430954457) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207N00000X Dermatology | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2022-07-21 |