Miedema, Brent W
Miedema, Brent W is an individual health care provider with primary practice located at 800 Hospital Dr # 617 , Columbia MO 65201-5275. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Miedema, Brent W can be contacted via phone (573) 814-6346.Contact Information
Primary practice address
800 Hospital Dr # 617
Columbia MO 65201-5275
Phone: (573) 814-6346
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MDR7N00 | Missouri |
Profile Details
| NPI number | 1033160734 |
|---|---|
| LBN Legal business name | Miedema, Brent W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Jul 19th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033160734 | NPPES |
| Missouri | Other | 20021458 | RR MEDICARE |
| Missouri | MEDICAID | 203229802 | RR MEDICARE |
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