Individual
DR. MELISSA A WHITSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
16 HAMPTON VILLAGE PLZ 220, SAINT LOUIS, MO 63109-2128
(314) 351-2004
(314) 351-0347
Mailing address
16 HAMPTON VILLAGE PLZ 220, SAINT LOUIS, MO 63109-2128
(314) 351-2004
(314) 351-0347
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2008015366
MO
261QP2300X
Primary Care Clinic/Center
Primary
2008015366
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578711420
TYPE 2 NPI
MO
05
—
1609879337
—
MO
01
—
2008015366
STATE LICENSE NUMBER
MO
Enumeration date
05/26/2005
Last updated
03/07/2023
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