Individual
MARVINA MOORE AMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3015 N BALLAS RD, ANESTHESIOLOGY DEPARTMENT - 2ND FL, SAINT LOUIS, MO 63131-2329
(314) 996-5330
Mailing address
3015 N BALLAS RD, ANESTHESIOLOGY DEPARTMENT - 2ND FL, SAINT LOUIS, MO 63131-2329
(314) 996-5330
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02756
KY
207L00000X
Anesthesiology Physician
033561
GA
207L00000X
Anesthesiology Physician
13461
MS
207L00000X
Anesthesiology Physician
Primary
200601640
MO
207L00000X
Anesthesiology Physician
2856
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205877800
—
MO
Enumeration date
06/08/2006
Last updated
07/28/2010
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