Individual
MR. J COLLINS CORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3009 N BALLAS RD, 383C, SAINT LOUIS, MO 63131-2322
(314) 996-4545
(314) 996-4546
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 996-4545
(314) 996-4546
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R9435
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200951028
—
MO
Enumeration date
02/16/2006
Last updated
01/19/2016
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