Provider Demographics
NPI:1922118355
Name:DINAUER, MARY C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:C
Last Name:DINAUER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:MSC 8515-87-1200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-6018
Mailing Address - Fax:314-454-2780
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED HEMATOLOGY & ONC, STE 9S
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6018
Practice Address - Fax:844-621-4392
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-11-15
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Provider Licenses
StateLicense IDTaxonomies
MO2012003240208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209536903Medicaid
ILENROLLEDMedicaid