Individual
DR. MARY ELIZABETH MANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD, SUITE 250C, ST LOUIS, MO 63131
(314) 567-9199
(314) 432-1524
Mailing address
180 WEIDMAN ROAD, SUITE 125, ST LOUIS, MO 63021
(636) 207-0277
(636) 207-0221
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
100216
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3944V19475
HCUSA
MO
Enumeration date
09/15/2006
Last updated
11/15/2012
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