Individual
DR. SHANNON GRACE FARMAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6031
(314) 251-6343
Mailing address
11475 OLDE CABIN RD STE 200, SAINT LOUIS, MO 63141-7129
(314) 991-8200
(314) 991-8206
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
M-14782
ID
2085P0229X
Pediatric Radiology Physician
MD60962082
WA
2085R0202X
Diagnostic Radiology Physician
0444325
KS
2085R0202X
Diagnostic Radiology Physician
Primary
200813456
MO
2085R0202X
Diagnostic Radiology Physician
M-14782
ID
Other
Enumeration date
06/05/2007
Last updated
11/17/2022
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