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General NPI Number Information
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NPI Number | 1033348057
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Entity Type | Individual
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Provider Name | DELENE PRENITA MUSIELAK M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2009
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 8857B LADUE RD
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2058
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Country | US
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Telephone | 314-682-3626
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Fax | 314-590-5954
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Provider Business Mailing Address
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Address Line | 8857B LADUE RD
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2058
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Country | US
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Telephone | 146-823-6263
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Fax | 314-590-5933
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 46271
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2019012317
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2019012317
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License Number State | MO
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