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1467013094
OSARENREN IDEMUDIA
SAINT LOUIS, MO
NPI
1467013094
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MO 2022024167)
Enumeration Date
2019-06-25
Last Update Date
2024-09-21
Business Address
OSARENREN IDEMUDIA MD
10010 KENNERLY RD
SAINT LOUIS, MO 63128-2106
Phone number: 314-517-2298
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Mailing Address
OSARENREN IDEMUDIA MD
10010 KENNERLY RD
SAINT LOUIS, MO 63128-2106
Phone number: 314-525-1328
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