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Individual

TEIDE BRISIBE EHIMARE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11325 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2722
(636) 825-2200
(636) 825-2201
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2012003220
MO

Other

Enumeration date
07/19/2007
Last updated
11/14/2022
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