Individual
MARY S BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3660 VISTA, SAINT LOUIS, MO 63110
(314) 577-8764
(314) 577-8125
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63110
(314) 977-4440
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R7C81
MO
Other
Enumeration date
08/04/2006
Last updated
03/18/2008
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