Individual
MADELINE BRUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
Mailing address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-7631
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2021012619
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2017
Last updated
01/18/2022
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