Individual
JEFFREY EDWARD DESMIDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3635 VISTA AVE, ST LOUIS UNIVERSITY HOSPITAL, SAINT LOUIS, MO 63110-2539
(314) 268-7133
Mailing address
1402 S GRAND BLVD RM M260, ST LOUIS UNIVERSITY SCHOOL OF MEDICINE, SAINT LOUIS, MO 63104-1004
(314) 977-9852
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2015016412
MO
Other
Enumeration date
06/20/2015
Last updated
06/20/2015
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