Individual
MARY C LIVERGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD STE 351C, SAINT LOUIS, MO 63131-2324
(314) 996-6800
Mailing address
3009 N BALLAS RD STE 351C, SAINT LOUIS, MO 63131-2324
(314) 996-6800
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2022010786
MO
207V00000X
Obstetrics & Gynecology Physician
70784
WI
207VM0101X
Maternal & Fetal Medicine Physician
Primary
2022010786
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093196842
—
WI
Enumeration date
06/17/2015
Last updated
08/02/2022
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