Individual
DR. ROSEMARY LOUISE CANNISTRARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D. PHD
Contact information
Practice address
11550 OLIVE BLVD, STE 140, CREVE COEUR, MO 63141-7111
(314) 205-8344
(314) 590-5931
Mailing address
11550 OLIVE BLVD, STE 140, CREVE COEUR, MO 63141-7111
(314) 205-8344
(314) 590-5931
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
100907
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00257143
RR MEDICARE
MO
Enumeration date
05/20/2006
Last updated
10/27/2011
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