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Individual

DENIANE JOHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
753 POINTE BASSE DR, STE GENEVIEVE, MO 63670-1820
(573) 883-2782
(573) 883-3681
Mailing address
PO BOX 366, STE GENEVIEVE, MO 63670-0366
(573) 883-4473

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022030257
MO
390200000X
Student in an Organized Health Care Education/Training Program
125-075238
IL

Other

Enumeration date
07/09/2019
Last updated
08/12/2022
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