Individual
JOHN EDWARD HARTWEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 HOSPITAL DR, SAINT PETERS, MO 63376-1659
(314) 317-0600
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2001032147
MO
208000000X
Pediatrics Physician
2001032147
MO
208M00000X
Hospitalist Physician
2001032147
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366443756
—
IL
05
—
208450809
—
MO
Enumeration date
08/09/2005
Last updated
05/08/2014
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