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Individual

RODOLFO MACEREN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
HWY 61S AT HWY 67, CRYSTAL CITY, MO 63019
(636) 933-1000
Mailing address
2 HOWE XING, FESTUS, MO 63028-4044
(636) 933-1000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R6445
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24219
CDS
MO
Enumeration date
05/12/2006
Last updated
03/07/2023
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