Individual
ELLEN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1465 S GRAND BLVD, ST. LOUIS, MO 63104-1003
(314) 268-4101
(314) 577-5379
Mailing address
3691 RUTGER AVE, ST. LOUIS, MO 63110-2515
(314) 977-6828
(314) 977-6872
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R7B94
MO
2080P0210X
Pediatric Nephrology Physician
Primary
R7B94
MO
Other
Enumeration date
08/05/2006
Last updated
09/16/2015
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