Individual
DR. LEMUEL YIA SIBULO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1402 S GRAND BLVD, M260, SAINT LOUIS, MO 63104-1004
(314) 977-9853
Mailing address
11361 CORSICA MIST AVE, LAS VEGAS, NV 89135-1338
(503) 330-0389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2021047392
MO
Other
Enumeration date
04/04/2017
Last updated
06/13/2023
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