Organization
ST. LOUIS ID, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL B. GUTWEIN M.D. (PRESIDENT)
(314) 395-8701
Entity
Organization
Contact information
Practice address
3009 N BALLAS RD, SUITE 130A, SAINT LOUIS, MO 63131-2322
(314) 395-8701
Mailing address
3009 N BALLAS RD, SUITE 130A, SAINT LOUIS, MO 63131-2322
(314) 395-8701
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
R7058
MO
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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