Individual
DR. DEREK SLOAN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
456 N NEW BALLAS RD STE 348, CREVE COEUR, MO 63141-6846
(314) 548-0265
Mailing address
PO BOX 78429, SAINT LOUIS, MO 63178-8429
(314) 548-0265
(314) 548-6555
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
036126443
IL
207RN0300X
Nephrology Physician
Primary
2014016671
MO
Other
Enumeration date
08/04/2008
Last updated
10/16/2023
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