Individual
GEORGE PELICAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2428 WOODSON RD, OVERLAND, MO 63114-5423
(314) 241-2424
Mailing address
PO BOX 31367, DES PERES, MO 63131-0367
(314) 845-0766
(314) 845-0766
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
33873
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PE200214906
—
MO
Enumeration date
08/12/2006
Last updated
07/08/2007
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