Provider Demographics
NPI:1982079810
Name:MORR VERENZUELA, CLAUDIA SOPHIA (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SOPHIA
Last Name:MORR VERENZUELA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16520 BARRISTER LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-4627
Mailing Address - Country:US
Mailing Address - Phone:404-436-5588
Mailing Address - Fax:
Practice Address - Street 1:1755 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1540
Practice Address - Country:US
Practice Address - Phone:314-256-3407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015028089207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology