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Individual

MICHAEL J ZEREGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 BREVCO PLZ, SUITE 208, LAKE ST LOUIS, MO 63367-2949
(636) 561-9020
(636) 561-6208
Mailing address
200 BREVCO PLZ, SUITE 208, LAKE ST LOUIS, MO 63367-2949
(636) 561-9020
(636) 561-6208

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2000154596
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1073505178
MO
01
18943
BC BS MO
01
P01015409
RAILROAD MEDICARE
MO
Enumeration date
08/16/2005
Last updated
04/02/2015
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