Provider Demographics
NPI:1730754995
Name:DOWDY, RIVER A
Entity type:Individual
Prefix:
First Name:RIVER
Middle Name:A
Last Name:DOWDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:P
Other - Last Name:BEAUCHEMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 CHALMERS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2417
Mailing Address - Country:US
Mailing Address - Phone:701-200-0115
Mailing Address - Fax:
Practice Address - Street 1:8000 BONHOMME AVE STE 406
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3515
Practice Address - Country:US
Practice Address - Phone:314-325-4658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date: