Individual
DR. MOYOSORE KIKELOMO ONIFADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2880 NETHERTON DR STE 200, SAINT LOUIS, MO 63136-4697
(636) 333-4500
(314) 521-4656
Mailing address
2880 NETHERTON DR STE 200, SAINT LOUIS, MO 63136-4697
(636) 333-4500
(314) 521-4656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2002019255
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208818716
—
MO
Enumeration date
08/17/2006
Last updated
06/19/2024
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