Individual
FABIANNE L. WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3201 ALFRED AVE, SAINT LOUIS, MO 63116-1809
(314) 776-4926
Mailing address
3201 ALFRED AVE, SAINT LOUIS, MO 63116-1809
(314) 776-4926
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2008025170
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0026461
INSTITUTIONAL PERMIT
—
Enumeration date
06/07/2007
Last updated
10/06/2008
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