Individual
DR. TATYANA IGOREVNA METELITSINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
360 S MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63703-4920
(573) 335-3577
(573) 335-1559
Mailing address
360 S MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63703-4920
(573) 335-3577
(573) 335-1559
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT192042
PA
207W00000X
Ophthalmology Physician
036-130196
IL
207W00000X
Ophthalmology Physician
2014039705
MO
207WX0107X
Retina Specialist (Ophthalmology) Physician
036-130196
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
2014039705
MO
Other
Enumeration date
08/14/2008
Last updated
12/11/2017
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