Individual
DR. TRAVIS WEAVER WINSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, STE 1B, SAINT LOUIS, MO 63110-1002
(314) 454-6062
(314) 454-4562
Mailing address
660 S EUCLID AVE, CB 8233, SAINT LOUIS, MO 63110-1010
(314) 747-2500
(314) 747-2599
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2019012462
MO
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
2019012462
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070814
—
MO
05
—
ENROLLED
—
IL
Enumeration date
05/01/2014
Last updated
11/09/2021
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