Individual
CARLA RUTH DUBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4414 N FLORISSANT AVE, SAINT LOUIS, MO 63107-1812
(314) 814-8531
(314) 814-8542
Mailing address
PO BOX 551, SAINT LOUIS, MO 63188-0551
(314) 814-8531
(314) 814-8542
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2011012286
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011012286
LICENSE
MO
Enumeration date
09/10/2012
Last updated
10/20/2016
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