Healthcare Provider Details

I. General information

NPI: 1720054448
Provider Name (Legal Business Name): CATHERINE M VANVOORN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 CORONA RD STE 102
COLUMBIA MO
65203-2582
US

IV. Provider business mailing address

2101 CORONA RD STE 102
COLUMBIA MO
65203-2582
US

V. Phone/Fax

Practice location:
  • Phone: 573-234-1800
  • Fax:
Mailing address:
  • Phone: 573-234-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36320
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number36320
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number36320
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: