Individual
MICHAEL J OMBRELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3660 VISTA AVE, SUITE 203, SAINT LOUIS, MO 63110-2540
(314) 977-8833
(314) 977-8818
Mailing address
1402 S GRAND BLVD, DOISY HALL RM 213A, SAINT LOUIS, MO 63104-1004
(314) 977-8833
(314) 977-8818
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2002011491
MO
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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