Individual
AUSTIN MONROE BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-8000
Mailing address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PENDING
MO
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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