Individual
DR. ALFREDO CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11133 DUNN RD, SAINT LOUIS, MO 63136-6119
(314) 653-5744
(314) 653-5613
Mailing address
11133 DUNN RD, SAINT LOUIS, MO 63136-6119
(314) 653-5744
(314) 653-5613
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MDR7797
MO
Other
Enumeration date
06/29/2007
Last updated
10/26/2007
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