Individual
DR. ANTHONY OMAVUAYE ODIBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4901 FOREST PARK AVE, DIV OBGYN MFM AND US, STE 710, SAINT LOUIS, MO 63108-1495
(314) 454-8181
(314) 747-1429
Mailing address
PO BOX 60352, SAINT LOUIS, MO 63160-0352
(314) 454-8181
(314) 747-1429
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
2021013428
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207611005
—
MO
Enumeration date
05/24/2005
Last updated
04/25/2024
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