Individual
DR. SHIRLEY MAE CATOIRE VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
11709 OLD BALLAS RD, SUITE 201, CREVE COEUR, MO 63141-7029
(314) 432-1903
(314) 432-5015
Mailing address
11709 OLD BALLAS RD, SUITE 201, CREVE COEUR, MO 63141-7029
(314) 432-1903
(314) 432-5015
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
07001117AMEMBER
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07001117A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2012026027
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07001117A
PODIATRIST LICENSE
IN
01
—
2012026027
PODIATRY LICENSE
MO
Enumeration date
11/24/2008
Last updated
08/02/2012
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