Individual
ILIA ROSA SUMOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1011 BOWLES AVE, SUITE G 50, FENTON, MO 63026-2395
(636) 496-4640
(636) 496-4962
Mailing address
1011 BOWLES AVE, SUITE G 50, FENTON, MO 63026-2395
(636) 496-4640
(636) 496-4962
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2011030407
MO
Other
Enumeration date
01/25/2008
Last updated
12/20/2021
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