Individual
SHALEN KOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12700 SOUTHFORK RD STE 100, SAINT LOUIS, MO 63128-3201
(314) 543-5284
(314) 543-5276
Mailing address
12700 SOUTHFORK RD STE 100, SAINT LOUIS, MO 63128-3201
(314) 543-5284
(314) 543-5276
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD.40953
AL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2022039230
MO
Other
Enumeration date
05/06/2015
Last updated
03/21/2023
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