Individual
DR. JULIE R FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1465 S. GRAND BLVD, ST. LOUIS, MO 63104
(314) 577-5360
(314) 268-4116
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, ST. LOUIS, MO 63110
(314) 977-6828
(317) 977-6777
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
2006007043
MO
208000000X
Pediatrics Physician
Primary
2006007043
MO
Other
Enumeration date
06/28/2006
Last updated
04/26/2024
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