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Individual

MR. GEORGE BENJAMIN MAXWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.A.

Contact information

Practice address
1430 OLIVE ST, SUITE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Mailing address
1430 OLIVE STREET, SUITE 400, ST. LOUIS, MO 63103-2317
(314) 206-3700

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
MO

Other

Enumeration date
02/15/2013
Last updated
02/15/2013
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