Individual
MR. MICHAEL E MIMLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1062 OLD DES PERES RD, SAINT LOUIS, MO 63131-1865
(314) 394-1660
(314) 394-1663
Mailing address
1062 OLD DES PERES RD, SAINT LOUIS, MO 63131-1865
(314) 394-1660
(314) 394-1663
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2017006602
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700441
UHC
MO
01
—
105971
BCBS
MO
05
—
208179317
—
MO
Enumeration date
07/12/2006
Last updated
06/11/2018
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