Provider Demographics
NPI:1578641718
Name:MAMINTA STREIFF, MARIA G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:G
Last Name:MAMINTA STREIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 N BALLAS
Mailing Address - Street 2:STE 120D
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131
Mailing Address - Country:US
Mailing Address - Phone:314-432-3669
Mailing Address - Fax:314-432-3118
Practice Address - Street 1:3023 N BALLAS
Practice Address - Street 2:STE 120D
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131
Practice Address - Country:US
Practice Address - Phone:314-432-3669
Practice Address - Fax:314-432-3118
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO36879207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
224345OtherGNP
109950OtherBCBS
224345OtherGNP
004013043Medicare ID - Type Unspecified