Individual
MICHAEL DANTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9979 WINGHAVEN BLVD, SUITE 206, O FALLON, MO 63368-3627
(636) 561-5291
(636) 561-5290
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(636) 561-5291
(636) 561-5290
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R6J55
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100375
BCBS
—
01
—
1200099
UHC FLORISSANT
MO
01
—
1200683
UHC
MO
01
—
132482
HEALTHLINK
MO
01
—
188961
GHP
MO
01
—
4259417
AETNA
MO
Enumeration date
11/04/2005
Last updated
09/21/2012
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