Individual
MISS MICHELE L NIEMCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11642 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 838-8220
(314) 830-1873
Mailing address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 367-7848
(314) 367-2985
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2005017812
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005017812
STATE LICENSE
MO
05
—
207489808
—
MO
Enumeration date
07/11/2006
Last updated
10/04/2024
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