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Individual

RONALD WEPPRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 MEDICAL PLZ, SUITE 101, LAKE SAINT LOUIS, MO 63367-1379
(636) 561-4100
(636) 561-8445
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(636) 561-4100
(636) 561-8445

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1D85
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000010042
ESSENCE
MO
01
0400583
UHC MEDICARE COMPLETE
01
0400699
UHC
MO
01
101349
HEALTHLINK
MO
01
105929
BCBS
MO
01
127500
GHP
MO
05
202392510
MO
01
4398418
AETNA
MO
01
A10490
MERCY
MO
Enumeration date
11/16/2005
Last updated
10/01/2012
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