Individual
DR. JESSICA SANJANA DOMINIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DEPT ANESTHESIOLOGY, SAINT LOUIS, MO 63110-1002
(800) 862-9980
(314) 362-1185
Mailing address
660 S EUCLID AVE, CB 8054, SAINT LOUIS, MO 63110-1010
(800) 862-9980
(314) 362-1185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2021025552
MO
207LP3000X
Pediatric Anesthesiology Physician
Primary
2021025552
MO
Other
Enumeration date
05/16/2016
Last updated
11/15/2021
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