Individual
DR. DELENE PRENITA MUSIELAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8857B LADUE RD, SAINT LOUIS, MO 63124-2058
(314) 682-3626
(314) 590-5954
Mailing address
8857B LADUE RD, SAINT LOUIS, MO 63124-2058
(146) 823-6263
(314) 590-5933
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019012317
MO
207R00000X
Internal Medicine Physician
46271
KY
208000000X
Pediatrics Physician
2019012317
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003159470A
—
GA
01
—
1033348057
BCBS-GA
GA
Enumeration date
07/12/2009
Last updated
02/17/2023
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