Individual
LUTHER J WILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-6082
(314) 977-6086
Mailing address
1008 SOUTH SPRING, PROVIDER ENROLLMENT, ST LOUIS, MO 63110
(314) 977-4440
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
31757
MO
2084N0600X
Clinical Neurophysiology Physician
31757
MO
Other
Enumeration date
07/17/2006
Last updated
10/28/2020
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