Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2016019457 | MO |
Y | 208600000X | Surgeon | 2016019457 | MO |
NPI | 1003266354 |
---|---|
Provider Name | Dr. Amelia Catherine Van Handel |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2016 |
Last Update Date | 11/10/2019 |