Individual
HUSSEIN EBRO WALIYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10012 KENNERLY RD STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1224
Mailing address
10012 KENNERLY RD STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1224
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2019024497
MO
208600000X
Surgery Physician
4301106134
MI
Other
Enumeration date
06/24/2014
Last updated
10/11/2023
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