Individual
MRS. JEANNE M DE MOTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
904 WOLLARD BLVD., RICHMOND, MO 64085
(816) 470-5432
(816) 470-7343
Mailing address
PO BOX 615, RICHMOND, MO 64085-0615
(816) 615-1413
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2002010572
MO
207Q00000X
Family Medicine Physician
2002010572
MO
2085B0100X
Body Imaging Physician
2002010572
MO
Other
Enumeration date
03/28/2007
Last updated
02/06/2015
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