Individual
DR. MICHAEL HARRY MASTROMICHALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 BOWLES AVE STE 425, FENTON, MO 63026-2384
(636) 496-5030
(636) 496-5025
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2008016598
MO
Other
Enumeration date
06/12/2007
Last updated
11/05/2020
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