Individual
SHAUN B HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10012 KENNERLY RD STE 102, SAINT LOUIS, MO 63128
(314) 849-6066
Mailing address
10012 KENNERLY RD STE 102, SAINT LOUIS, MO 63128-2197
(314) 849-6066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C10011397
DE
207RH0000X
Hematology (Internal Medicine) Physician
Primary
2019020900
MO
Other
Enumeration date
03/20/2012
Last updated
08/06/2019
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