Individual
DR. DAMON R. BROYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 S NEW BALLAS RD STE 150, SAINT LOUIS, MO 63141-8728
(636) 237-4025
(636) 237-4030
Mailing address
701 S NEW BALLAS RD STE 150, SAINT LOUIS, MO 63141-8728
(636) 237-4025
(636) 237-4030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004002145
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208987800
—
MO
Enumeration date
07/21/2005
Last updated
08/20/2024
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