Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 2019017634 | MO |
NPI | 1033569132 |
---|---|
Provider Name | Dr. Anne Marie Maestas |
First Address | Saint Louis, MO 63195-5534 |
Second Address | Troy, MO 63379-2823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2016 |
Last Update Date | 23/10/2020 |