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Individual

AMY A MOSHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3015 N NEW BALLAS RD, ST LOUIS, MO 63131
(314) 966-5180
(314) 821-2180
Mailing address
55 WESTPORT PLZ, SUITE 300, SAINT LOUIS, MO 63146-3109
(314) 548-4772
(314) 548-4748

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036114248
IL
2085R0202X
Diagnostic Radiology Physician
Primary
R4H51
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0090000352
IL BLUE
01
010013128
MO CARE
01
018012444
CARE
01
1390
MO BLUE
01
141835
H LINK
01
1650512
PH PLAN
01
203077003
MO CAID
01
24349
BLUE CHOICE
01
2781
GHP
01
300066989
RR CARE
01
300066996
RR CARE
01
398021
HLT PART
01
431725842MID
MERCY
01
6661
HCARE USA
01
E12419
GATE WAY
Enumeration date
07/17/2006
Last updated
03/18/2009
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