Individual
KIMBERLY WALL LEDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6420 CLAYTON RD, RICHMOND HEIGHTS, MO 63117-1811
(314) 768-8360
Mailing address
6453 CECIL AVE, CLAYTON, MO 63105-2224
(314) 725-7787
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
114588
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203801717
—
MO
Enumeration date
09/21/2006
Last updated
08/30/2013
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