Organization
AFFTON MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBILINDA CASINO M.D. (PRESIDENT)
(314) 638-9309
Entity
Organization
Contact information
Practice address
84 GRASSO PLAZA, ST LOUIS, MO 63123
(314) 638-9309
(314) 637-9333
Mailing address
PO BOX 4341, SAINT LOUIS, MO 63123-0141
(314) 638-9309
(314) 638-9333
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50291440
—
MO
Enumeration date
08/24/2007
Last updated
03/01/2012
Update your record
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