Individual
DEVERA ELCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6031
Mailing address
555 N NEW BALLAS RD, SUITE 150, SAINT LOUIS, MO 63141-6825
(314) 991-8200
(314) 991-8206
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
R6245
MO
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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