Individual provider · Type 1 NPI

Robert Cory Proffer, PHYSICIAN ASSISTANT

Medical Physician Assistant · St. Louis, MO

NPI number 1376174417 Active

Practice location

607 S New Ballas Rd Ste 2300
St. Louis, MO 63141-8234

Call (314) 931-5990 Map

Mailing address

355 Peffer Ln
Fenton, MO 63026-2824

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1376174417

Robert Cory Proffer, PHYSICIAN ASSISTANT's National Provider Identifier is 1376174417, issued on Jan 28, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Louis, MO. The record was last updated on Jan 28, 2020.