Organization
CRESTVIEW MEDICAL ASSOCIATES, LLC
Active
Organization
CRESTVIEW MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL BARTO VATTEROTT M.D. (OWNER)
(636) 561-8100
Entity
Organization
Contact information
Practice address
107 BREVCO PLZ, LAKE ST LOUIS, MO 63367-1399
(636) 561-8100
(636) 561-3396
Mailing address
107 BREVCO PLZ, LAKE ST LOUIS, MO 63367-1399
(636) 561-8100
(636) 561-3396
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207R0000X
MO
Other
Enumeration date
01/24/2006
Last updated
09/28/2007
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