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NPI Code Detail

MEDICARE: DR. PEGGY WANNER-BARJENBRUCH MD

MEDICARE: DR. PEGGY WANNER-BARJENBRUCH 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
1207R00000XInternal Medicine PhysicianR2F18MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326023185
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEGGY WANNER-BARJENBRUCH MD
Provider Business Mailing Address
First Line : 600 MEDICAL PARK DR
Second Line :
City : MEXICO
State : MO
Zip : 65265-3724
Country : US
Telephone Number : 573-581-1040
Fax Number : 573-581-5397
Provider Business Practice Location Address
First Line : 600 MEDICAL PARK DR
Second Line :
City : MEXICO
State : MO
Zip : 65265-3724
Country : US
Telephone Number : 573-581-8500
Fax Number : 573-581-5397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 10/28/2022

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