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NPI Code Detail

MEDICARE: MANICIA DOSS

MEDICARE: MANICIA DOSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian2023049173MO

General Provider Information

NPI Number : 1720604945
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANICIA DOSS
Provider Business Mailing Address
First Line : 3301 COMMONWEALTH AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63143-3505
Country : US
Telephone Number : 503-380-0906
Fax Number :
Provider Business Practice Location Address
First Line : 3301 COMMONWEALTH AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63143-3505
Country : US
Telephone Number : 503-380-0906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2020
Last Update Date : 01/31/2025

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Directions to “ MANICIA DOSS ” Practice Location

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