Healthcare Provider Details

I. General information

NPI: 1619920097
Provider Name (Legal Business Name): TROY DEAN SCHEIDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W NIFONG BLVD BUILDING 3, SUITE 100
COLUMBIA MO
65203-5615
US

IV. Provider business mailing address

1000 W NIFONG BLVD BUILDING 3, SUITE 100
COLUMBIA MO
65203-5615
US

V. Phone/Fax

Practice location:
  • Phone: 573-214-2000
  • Fax: 573-214-2042
Mailing address:
  • Phone: 573-214-2000
  • Fax: 573-214-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2004012772
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: