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Individual
DR. ANDREW JOEL REVELLE
Active
Individual
DR. ANDREW JOEL REVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2015013067
MO
207RB0002X
Obesity Medicine (Internal Medicine) Physician
ED0312A
WV
208M00000X
Hospitalist Physician
Primary
2015013067
MO
Other
Enumeration date
07/31/2012
Last updated
06/27/2016
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