Individual
PAUL DAVID HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3900
(314) 543-5294
(314) 892-1658
Mailing address
2900 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3900
(314) 543-5294
(314) 892-1658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2010019760
MO
208000000X
Pediatrics Physician
2010019760
MO
Other
Enumeration date
07/01/2010
Last updated
03/15/2017
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