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Individual

KIMBERLY G PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
300 1ST CAPITOL DR, SAINT CHARLES, MO 63301-2844
(636) 947-5000
(636) 947-5090
Mailing address
1836 LACKLAND HILL PKWY, ATTN: CREDENTIALING, SAINT LOUIS, MO 63146-3572
(314) 989-0300
(314) 810-1399

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
101732
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578500039
MO
Enumeration date
06/01/2006
Last updated
01/06/2010
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