Individual
DR. LISA S. ETZWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
621 S NEW BALLAS RD, ST. JOHN'S MERCY MEDICAL CENTER, SUITE 6006, TOWER B, CREVE COEUR, MO 63141-8232
(314) 251-6299
(314) 251-4450
Mailing address
16522 BAXTER FOREST RIDGE DR, CHESTERFIELD, MO 63005-4661
(636) 519-1655
(636) 536-4973
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
102051
MO
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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