Individual
DR. FREDERICK BERTHOLD DURER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD STE 360C, SAINT LOUIS, MO 63131
(314) 996-7220
(314) 996-7225
Mailing address
3009 N BALLAS RD STE 360C, SAINT LOUIS, MO 63131-2349
(314) 996-7220
(314) 996-7225
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
103603
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208863100
—
MO
Enumeration date
07/05/2005
Last updated
03/12/2021
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