Individual
DR. CRYSTAL NNENNE AZU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV IM CARDIOLOGY, STE 8B, SAINT LOUIS, MO 63110-1032
(314) 362-1291
(314) 362-4278
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1291
(314) 362-4278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2024030894
MO
207RC0000X
Cardiovascular Disease Physician
Primary
2024030894
MO
2085R0202X
Diagnostic Radiology Physician
2024030894
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200146372
—
MO
Enumeration date
06/15/2017
Last updated
04/15/2025
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