Healthcare Provider Details

I. General information

NPI: 1720122294
Provider Name (Legal Business Name): CHRISTOPHER MARET M.D.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 WATSON RD SUITE 201
SAINT LOUIS MO
63109-1251
US

IV. Provider business mailing address

3915 WATSON RD SUITE 201
SAINT LOUIS MO
63109-1251
US

V. Phone/Fax

Practice location:
  • Phone: 314-647-9797
  • Fax: 314-647-1665
Mailing address:
  • Phone: 314-647-9797
  • Fax: 314-647-1665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR3C16
License Number StateMO

VIII. Authorized Official

Name: DR. CHRISTOPHER MARET
Title or Position: OWNER
Credential: M. D.
Phone: 314-647-9797