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Individual

DR. AMY JO RAVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1031 BELLEVUE AVE STE 400, SAINT LOUIS, MO 63117-1858
(314) 977-7455
(314) 977-7343
Mailing address
6420 CLAYTON RD STE 290, SAINT LOUIS, MO 63117-1811
(314) 781-8605
(314) 781-2840

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2000157500
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518963859
NPI
MO
05
205054802
MO
Enumeration date
06/22/2005
Last updated
01/13/2021
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