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Individual

KENYATTA D NORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1209 WASHINGTON AVE, STE 518, SAINT LOUIS, MO 63103-1996
(317) 345-7518
Mailing address
1209 WASHINGTON AVE, STE 518, SAINT LOUIS, MO 63103-1996
(317) 345-7518

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036128850
IL

Other

Enumeration date
08/06/2007
Last updated
02/05/2014
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