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Individual

DR. ANTHONY JOSEPH D'ANGELO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2315 DOUGHERTY FERRY ROAD, SUITE 103, ST. LOUIS, MO 63122
(314) 821-5002
Mailing address
2315 DOUGHERTY FERRY ROAD, SUITE 103, ST. LOUIS, MO 63122-4323
(314) 821-5002
(314) 821-5029

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
R3J23
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
242700706
MO
Enumeration date
08/09/2005
Last updated
12/30/2009
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