Individual
SHULAMIT MENASHE PORTNOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1465 S GRAND BLVD, ST. LOUIS, MO 63104-1003
(314) 577-5609
(314) 268-4028
Mailing address
PO BOX 503900, SAINT LOUIS, MO 63150-3900
(314) 577-5609
(314) 268-4028
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2003001990
MO
2080P0006X
Developmental - Behavioral Pediatrics Physician
2003001990
MO
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
2003001990
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208419606
—
MO
Enumeration date
06/21/2005
Last updated
01/11/2021
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