Individual
DR. PETA-GAY SIMONE NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
660 S EUCLID AVE, BOX 8072, SAINT LOUIS, MO 63110-1010
(314) 362-0478
Mailing address
4444 W PINE BLVD, APT 308, SAINT LOUIS, MO 63108-2349
(586) 703-3781
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2009012951
MO
Other
Enumeration date
06/30/2009
Last updated
03/05/2013
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