Individual
DR. DJAMEL BOUAZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(716) 255-6305
Mailing address
704 8TH ST, NIAGARA FALLS, NY 14301-1758
(716) 255-6305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2024032260
MO
Other
Enumeration date
11/23/2024
Last updated
11/23/2024
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