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
Phone: (573) 875-9400
Fax: (573) 874-1547
Website:
Health care specialties
| Specialty | Code | License # | 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 4 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 | 1205995008 | NPPES |
| Missouri | MEDICAID | 205647605 |
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