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Individual

RICHARD G MRAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 317-0600
(314) 317-0606
Mailing address
12125 WOODCREST EXECUTIVE DR, SUITE 220, SAINT LOUIS, MO 63141-5001
(314) 317-0600
(314) 317-0600

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R3G47
MO
208M00000X
Hospitalist Physician
R3G47
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972573715
MO
Enumeration date
01/24/2006
Last updated
06/13/2012
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