Individual
OCTAVE C MERVEILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 S HOCKER DR, INDEPENDENCE, MO 64055-4723
(913) 384-0834
Mailing address
6500 ABERDEEN RD, MISSION HILLS, KS 66208-1821
(913) 384-0834
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
33146
MO
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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