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Organization

PAUL ROTTLER MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL ROTTLER M.D. (PRESIDENT)
(131) 496-6880
Entity
Organization

Contact information

Practice address
13625 BIG BEND ROAD, ST. LOUIS, MO 63122-5568
(131) 496-6888
(131) 496-6581
Mailing address
13625 BIG BEND ROAD, ST. LOUIS, MO 63122-5568
(131) 496-6888
(131) 496-6581

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
R9G51
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000008690
MEDICARE ID NUMBER
MO
Enumeration date
05/29/2009
Last updated
07/13/2009
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