Provider Demographics
NPI:1144231770
Name:PHILIPNERI, MARIE D (MD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:D
Last Name:PHILIPNERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3691 RUTGER AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-977-4440
Mailing Address - Fax:
Practice Address - Street 1:1008 S SPRING AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2520
Practice Address - Country:US
Practice Address - Phone:314-977-2650
Practice Address - Fax:314-771-0784
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2021-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2000158773207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology