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Individual

DR. ALEXANDER K MAMMEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4530 LEMAY FERRY RD, SUITE M, SAINT LOUIS, MO 63129-1600
(314) 487-8724
(314) 487-0443
Mailing address
4530 LEMAY FERRY RD, SUITE M, SAINT LOUIS, MO 63129-1600
(314) 487-8724
(314) 487-0443

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36849
MO

Other

Enumeration date
07/12/2005
Last updated
10/16/2017
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