Organization
EVOLUTION MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE MARINO PARRA MD (OWNER)
(636) 534-0200
Entity
Organization
Contact information
Practice address
522 N NEW BALLAS RD STE 317, CREVE COEUR, MO 63141-6840
(636) 534-0200
(636) 534-0201
Mailing address
PO BOX 37002, SAINT LOUIS, MO 63141-1502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
04/11/2022
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