SOSTANIE TAKOTA ENORU

JEFFERSON CITY, MO
NPI1740671254
Other NameSOSTANIE TAKOTA ENORU
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: MO  2022031212)
Additional Taxonomies207R00000X Internal Medicine
(Licence: NY  292675)
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: NY  292675)
207RI0011X Internal Medicine, Interventional Cardiology
(Licence: MO  2022031212)
208M00000X Hospitalist
(Licence: NY  292675)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: NY  292675)
Enumeration Date2015-02-05
Last Update Date2022-08-08
Business Address
Dr. SOSTANIE TAKOTA ENORU M.D.
3501 W TRUMAN BLVD # A
JEFFERSON CITY, MO 65109-0514
Phone number: 573-636-0635
Mailing Address
Dr. SOSTANIE TAKOTA ENORU M.D.
PO BOX 363
JEFFERSON CITY, MO 65102-0363
Phone number: 573-636-0635