Individual
DR. MARK MILLER SHULDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8782
Mailing address
1402 S GRAND BLVD, PATHOLOGY, SAINT LOUIS, MO 63104-1004
(314) 577-8782
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
2013010528
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2013010528
MO
Other
Enumeration date
07/01/2010
Last updated
05/02/2016
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