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NPI Code Detail

MEDICARE: SUE M DOERHOFF MSW

MEDICARE: SUE M DOERHOFF MSW
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
1104100000XSocial Worker004163MO

General Provider Information

NPI Number : 1841276839
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE M DOERHOFF MSW
Provider Business Mailing Address
First Line : 424 W ROBIN RIDGE RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-9350
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 HOSPITAL DR
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-5275
Country : US
Telephone Number : 573-814-6000
Fax Number : 573-814-6493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 07/08/2007

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