Individual
MARIAM CHOWDHRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
12855 N 40 DR STE 125, SAINT LOUIS, MO 63141-8663
(314) 966-0111
Mailing address
12855 N 40 DR STE 125, SAINT LOUIS, MO 63141-8663
(314) 966-0111
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036.128935
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2014018795
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036128935
—
IL
Enumeration date
03/17/2008
Last updated
03/17/2018
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