Provider Demographics
NPI:1831110618
Name:GIUFFRA, LUIS A (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:GIUFFRA
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9890 CLAYTON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1685
Mailing Address - Country:US
Mailing Address - Phone:314-725-1515
Mailing Address - Fax:314-725-1654
Practice Address - Street 1:9890 CLAYTON RD
Practice Address - Street 2:STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1685
Practice Address - Country:US
Practice Address - Phone:314-725-1515
Practice Address - Fax:314-725-1654
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOMD1032572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209768217Medicaid
MO209768217Medicaid
MO000094875Medicare ID - Type Unspecified
MO000094875Medicare PIN