Individual
HARRY L WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD, SUITE 100B, SAINT LOUIS, MO 63131-2322
(314) 432-1111
(314) 432-6308
Mailing address
26 NANTUCKET LN, SAINT LOUIS, MO 63132-4137
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
R7P48
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110054267
RR MEDICARE
MO
01
—
148998
HEALTHLINK
MO
01
—
24916
BC/BS
MO
01
—
47310
GHP
MO
Enumeration date
08/24/2005
Last updated
01/08/2014
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