Provider Demographics
NPI:1407019300
Name:BAUMANN-DUDENHOEFFER, AIMEE MARGUERITE (MD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:MARGUERITE
Last Name:BAUMANN-DUDENHOEFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:NWT 8328 CB 8116
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-6148
Mailing Address - Fax:314-454-4633
Practice Address - Street 1:1 CHILDRENS PL STE C
Practice Address - Street 2:STE C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6148
Practice Address - Fax:314-454-4633
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012018779208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1407019300Medicaid
ILENROLLEDMedicaid