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Individual

DR. CHRISTINA M MANNIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5395
(314) 268-6459
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5395
(314) 268-6459

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036108876
IL
208000000X
Pediatrics Physician
2007027356
MO
208M00000X
Hospitalist Physician
Primary
2007027356
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036108876
IL
Enumeration date
09/07/2006
Last updated
07/16/2024
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