Individual
DANITA COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1035 BELLEVUE AVE STE 206, SAINT LOUIS, MO 63117-1846
(314) 645-3677
(314) 644-3235
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-1854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
101702
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207740804
—
MO
Enumeration date
11/28/2005
Last updated
10/20/2020
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