Individual
ANDREW G WEGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1601 WENTZVILLE PKWY STE 117, WENTZVILLE, MO 63385-3814
(636) 332-8455
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.005405
IL
363A00000X
Physician Assistant
Primary
2016007767
MO
Other
Enumeration date
05/18/2015
Last updated
09/23/2021
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