Doctor Name: | DR. CRISTINA C WALDEN |
NPI Number: | 1992991954 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 108432 |
Business Practice Address: | 1 Brookings Dr Saint Louis, MO - 631304862 |
Business Phone Number: | 3149356666 |
Business Fax Number: | 3149358515 |
Mailing Address: | 1201 Brookings Dr, C B 1201 SAINT LOUIS |
State: | MO |
Postal Code: | 63130 |
Phone Number: | 3149356666 |
Fax Number: | 3149355781 |
NPI Enumeration Date: | 09/23/2007 |
NPI Last Update Date: | 10/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 108432 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |