Healthcare Provider Details

I. General information

NPI: 1770814014
Provider Name (Legal Business Name): ARVIN GARCIA ABUEG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E OUTER RD S STE 4
CANTON MO
63435-1702
US

IV. Provider business mailing address

1025 MAINE ST
QUINCY IL
62301-4096
US

V. Phone/Fax

Practice location:
  • Phone: 573-288-5949
  • Fax: 573-288-5755
Mailing address:
  • Phone: 217-222-6550
  • Fax: 217-277-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01067718A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010020378
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: