Mark C Eddy, MD
Pediatrics, Pediatric Endocrinology in Saint Louis, MO. Individual provider (NPI-1).
NPI number1760596126
StatusActive
Last updated in NPPESJan 15, 2021
Details
- NPI
- 1760596126
- Entity type
- Individual (NPI-1)
- Name
- Mark C Eddy
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2006
- Certification date
- Jan 15, 2021
- Last updated
- Jan 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0205X | Pediatrics, Pediatric Endocrinology | 105496 | MO | Yes |
Practice location
1465 S Grand BlvdSaint Louis, MO 63104-1003
Phone 314-577-5648 · Fax 314-268-6448
Mailing address
1465 S Grand BlvdSaint Louis, MO 63104-1003
Phone 314-268-4010 · Fax 314-268-6448
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