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NPI Code Detail

MEDICARE: SERGIO G CRUZ M.D.

MEDICARE: SERGIO G CRUZ M.D.
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 Physician33254MO

General Provider Information

NPI Number : 1952326860
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERGIO G CRUZ M.D.
Provider Business Mailing Address
First Line : 3800 S NATIONAL AVE
Second Line : #540
City : SPRINGFIELD
State : MO
Zip : 65807-5209
Country : US
Telephone Number : 417-269-6262
Fax Number : 417-269-4349
Provider Business Practice Location Address
First Line : 801 N LINCOLN AVE
Second Line :
City : MONETT
State : MO
Zip : 65708-1641
Country : US
Telephone Number : 417-236-2460
Fax Number : 417-236-2560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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Directions to “ SERGIO G CRUZ M.D.” Practice Location

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