Individual
MARK D RICKMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
714 GRAVOIS RD, STE 210, FENTON, MO 63026-7723
(314) 543-5230
(314) 543-5280
Mailing address
714 GRAVOIS RD, STE 210, FENTON, MO 63026-7723
(636) 660-9850
(636) 660-9851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
106510
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243764602
—
MO
Enumeration date
06/21/2006
Last updated
04/17/2020
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