Individual
AYOTUNDE MARK BAMIMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
400 1ST CAPITOL DR STE 401, SAINT CHARLES, MO 63301-2886
(636) 669-2220
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-2551
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2012-00809
NC
207RC0000X
Cardiovascular Disease Physician
2013027460
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2013027460
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920619
—
NC
Enumeration date
01/08/2008
Last updated
10/20/2020
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