MEDICARE: DR. ERSKINE HUNTER IV MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	2024025235	MO

General Provider Information

NPI Number	:	1821792573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERSKINE HUNTER IV MD

Provider Business Mailing Address
First Line	:	1 HOSPITAL DR # 58.00
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65212-1000
Country	:	US
Telephone Number	:	573-882-4438
Fax Number	:	573-884-9992

Provider Business Practice Location Address
First Line	:	1021 HITT ST
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65212-3022
Country	:	US
Telephone Number	:	738-824-4385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	07/09/2024

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