Provider Demographics
NPI:1043204597
Name:CRONIN, CHRISTOPHER S (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:CRONIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:226 S WOODS MILL RD
Mailing Address - Street 2:SUITE 49 W
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3662
Mailing Address - Country:US
Mailing Address - Phone:314-434-1211
Mailing Address - Fax:314-434-4419
Practice Address - Street 1:226 S WOODS MILL RD
Practice Address - Street 2:SUITE 49 W
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-434-1211
Practice Address - Fax:314-434-4419
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2015-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO11129208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208582825Medicaid
MOG40710Medicare UPIN
MO004011106Medicare ID - Type Unspecified