Individual
DR. DIKSON DIBE GONDIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
660 S EUCLID AVE, BOX 8118, SAINT LOUIS, MO 63110-1010
(314) 362-7472
Mailing address
660 S EUCLID AVE, BOX 8118, SAINT LOUIS, MO 63110-1010
(314) 362-7472
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2013020666
MO
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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