Individual
ANDREA DIANE ITZKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8710 MANCHESTER RD, SAINT LOUIS, MO 63144-2724
(314) 961-3570
Mailing address
PO BOX 1239, TROY, MI 48099-1239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012011172
MO
207R00000X
Internal Medicine Physician
ME51683
FL
Other
Enumeration date
04/06/2006
Last updated
10/14/2015
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