Individual
DR. SCOTT P WASSERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1110 HIGHLANDS PLAZA DR E, STE 375, SAINT LOUIS, MO 63110-1392
(314) 367-3113
(314) 454-9382
Mailing address
PO BOX 7412035, CHICAGO, IL 60674-2035
(314) 367-3113
(314) 454-9382
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
108667
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209809714
—
MO
Enumeration date
05/23/2006
Last updated
04/18/2025
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