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GENEVIEVE A DELROSARIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 977-8635
(314) 977-8649
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 977-8635
(314) 977-8649

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-00777
KS
363A00000X
Physician Assistant
Primary
2012017129
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100409070A
KS
01
425910
FIRSTGUARD
KS
01
970022263
RR MEDICARE
Enumeration date
08/30/2006
Last updated
01/25/2021
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