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Individual

DR. JUSTIN H DUREL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
621 S NEW BALLAS RD, SUITE 695A, SAINT LOUIS, MO 63141-8232
(314) 872-7400
(314) 872-9126
Mailing address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R6355
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112119
BLUE CROSS BLUE SHIELD
MO
01
130335
HEALTHLINK
MO
01
4291695
AETNA
MO
Enumeration date
06/18/2006
Last updated
07/08/2007
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