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Individual

DR. CARRIE ELISE JOHANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
12700 SOUTHFORK RD STE 260, SAINT LOUIS, MO 63128-3288
(314) 543-5270
(314) 543-5272
Mailing address
12700 SOUTHFORK RD STE 260, SAINT LOUIS, MO 63128-3288
(314) 543-5270
(314) 543-5272

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
036142583
IL
208800000X
Urology Physician
Primary
2019024779
MO

Other

Enumeration date
06/12/2012
Last updated
02/05/2025
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