Individual
ANDREW MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, MSC 8208-0016-01, ST. LOUIS, MO 63110
(314) 454-2527
(314) 747-8880
Mailing address
1 CHILDRENS PL, MSC 8208-0016-01, ST. LOUIS, MO 63110
(314) 454-2527
(314) 747-8880
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2023011017
MO
208D00000X
General Practice Physician
0101273926
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2020
Last updated
08/01/2023
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