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Individual

WANDA T TERRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1110 HIGHLANDS PLAZA DR E STE 220, SAINT LOUIS, MO 63110-1351
(314) 273-0195
Mailing address
1110 HIGHLANDS PLAZA DR E STE 220, SAINT LOUIS, MO 63110-1351
(314) 273-0195

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R4C00
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206913113
MO
Enumeration date
07/03/2006
Last updated
05/15/2023
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