| Organization Name: | BOONSLICK MEDICAL GROUP INC |
| NPI Number: | 1588662803 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT B CUSWORTH (PRESIDENT, BOONSLICK MED.GROUP INC) |
| Mailing Address: | 201 Bjc Saint Peters Dr Suite 100 Saint Peters |
| State: | MO US |
| Postal Code: | 633763091 |
| Phone Number: | 6369168228 |
| Fax Number: | 6369465774 |
| NPI Enumeration Date: | 07/11/2005 |
| NPI Last Update Date: | 01/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |