Individual
MRS. SHANTERIAN WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2020010508
MO
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2020010508
MO
Other
Enumeration date
03/30/2015
Last updated
11/21/2025
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