Individual
DR. MARISSA OMURTAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD, DEPT. OF ANESTHESIA, SAINT LOUIS, MO 63141-8221
(314) 251-4687
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 200-4243
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
002828
GA
207L00000X
Anesthesiology Physician
Primary
2011013954
MO
Other
Enumeration date
01/26/2008
Last updated
12/29/2011
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