Individual
DR. NATHAN C WILGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1402 S GRAND BLVD, SAINT LOUIS, MO 63104-1004
(314) 577-8694
Mailing address
3450 RUSSELL BLVD, APT. 106, SAINT LOUIS, MO 63104-1593
(903) 276-7150
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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