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Organization

DR. M. K. ONIFADE INTERNAL MEDICINE PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOYOSORE KIKELOMO ONIFADE M.D. (MANAGER)
(314) 355-5300
Entity
Organization

Contact information

Practice address
2880 NETHERTON DR STE 200, SAINT LOUIS, MO 63136-4697
(314) 355-5300
(314) 521-4656
Mailing address
2880 NETHERTON DR STE 200, SAINT LOUIS, MO 63136-4697
(314) 355-5300
(314) 521-4656

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2002019255
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208818716
MO
Enumeration date
05/15/2007
Last updated
10/21/2024
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