Individual
BRYCE DECIDUE STASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 CHOUTEAU AVE, SAINT LOUIS, MO 63103-3112
(325) 660-4747
Mailing address
1720 CHOUTEAU AVE, SAINT LOUIS, MO 63103-3112
(325) 660-4747
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2016019983
MO
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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