Individual
GERALD LIONELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
224 S WOODS MILL RD, SUITE 450 SOUTH, CHESTERFIELD, MO 63017-3513
(314) 843-0900
(314) 843-0904
Mailing address
PO BOX 419074, CREVE COEUR, MO 63141-9074
(314) 843-0900
(314) 843-0904
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2002010427
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001907
—
MO
Enumeration date
08/29/2006
Last updated
03/15/2016
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