Provider Demographics
NPI:1700903820
Name:DOYLE, MARIA BERNADETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:BERNADETTE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-747-9889
Mailing Address - Fax:314-361-4197
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV SURG TRANSPLANT, STE 12B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-747-9889
Practice Address - Fax:314-361-4197
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008024818204F00000X, 2086S0102X, 2086X0206X, 208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205473804Medicaid
ILENROLLEDMedicaid
MO965480181Medicare PIN
MOP00398647Medicare PIN