Individual
ANDRES ALEJANDRO MATA HIDALGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 617-2650
Mailing address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 617-2650
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2025028046
MO
208M00000X
Hospitalist Physician
Primary
2025028046
MO
Other
Enumeration date
03/22/2021
Last updated
07/11/2025
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