Provider Demographics
NPI:1053318535
Name:HUSTER, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:HUSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1500 N CHURCH RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-7129
Mailing Address - Country:US
Mailing Address - Phone:816-781-9620
Mailing Address - Fax:816-781-0986
Practice Address - Street 1:1500 N CHURCH RD
Practice Address - Street 2:SUITE C
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-7129
Practice Address - Country:US
Practice Address - Phone:816-781-9620
Practice Address - Fax:816-781-0986
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOMO R9543207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA25207Medicare UPIN
MOD320000Medicare ID - Type UnspecifiedID NUMBER MEDICARE