Individual
DR. MICHELLE MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 678-3044
Mailing address
3526 VISTA AVE APT B, SAINT LOUIS, MO 63104-1006
(210) 900-6243
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01062224A
IN
207LP3000X
Pediatric Anesthesiology Physician
Primary
N3822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346466091
—
TX
Enumeration date
04/18/2007
Last updated
01/12/2021
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