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1942759493
MELANIE EILEEN WHITESIDES
SAINT LOUIS, MO
NPI
1942759493
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Former Name
MELANIE EILEEN DIAZ
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367H00000X Anesthesiologist Assistant
(Licence: MO 2016034131)
Enumeration Date
2016-09-26
Last Update Date
2020-02-03
Business Address
Mrs. MELANIE EILEEN WHITESIDES CAA
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
Phone number: 636-386-9224
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Mailing Address
Mrs. MELANIE EILEEN WHITESIDES CAA
339 CONSORT DR
BALLWIN, MO 63011-4439
Phone number: 636-386-9224
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