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General NPI Number Information
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NPI Number | 1316057565
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Entity Type | Organization
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Legal Business Name | WESTEND MEDICAL CENTER PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 6125 CLAYTON AVE STE 118
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City | SAINT LOUIS
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State | MO
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Zip | 63139-3265
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Country | US
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Telephone | 314-367-4044
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Fax | 314-367-1440
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Provider Business Mailing Address
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Address Line | 6125 CLAYTON AVE STE 118
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City | SAINT LOUIS
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State | MO
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Zip | 63139-3265
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Country | US
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Telephone | 314-367-4044
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Fax | 314-367-1440
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. VALERIE O WALKER
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Credential | M.D.
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Telephone | 314-367-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | R9B43
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License Number State | MO
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