Koburov, George T

Koburov, George T is an individual health care provider with primary practice located at 404 N Keene St , Columbia MO 65201-6626. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as his primary health care specialty. Koburov, George T can be contacted via phone (573) 875-9400.

Contact Information

Primary practice address
404 N Keene St Columbia MO 65201-6626
Fax: (573) 874-1547
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 2012015982 Missouri

Profile Details

NPI number 1205995008
LBN Legal business name Koburov, George T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2006
Last updated Sep 2nd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205995008 NPPES
Missouri MEDICAID 205647605

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