Individual
PHILIP C TROTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13303 TESSON FERRY RD, SAINT LOUIS, MO 63128-4062
(314) 843-5888
(314) 843-1905
Mailing address
PO BOX 411515, SAINT LOUIS, MO 63141-3515
(314) 333-6750
(314) 432-0178
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036053242
IL
2085R0202X
Diagnostic Radiology Physician
Primary
32168
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053242
—
IL
05
—
200664902
—
MO
01
—
300099726
RAILROAD MEDICARE
MO
01
—
300102465
RAILROAD MEDICARE
MO
Enumeration date
07/21/2006
Last updated
10/18/2011
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