Individual
SHANNON J POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3466 MCKELVEY RD, BRIDGETON, MO 63044-2533
(314) 463-6950
Mailing address
660 MASON RIDGE CENTER DR STE 300, SAINT LOUIS, MO 63141-8512
(314) 448-3791
(636) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2010017998
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2010
Last updated
09/22/2025
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