Organization
ST LOUIS COUNTY OTOLARYNGOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD WILLIAM MORITZ MD (PHYSICIAN/SURGEON)
(314) 291-8787
Entity
Organization
Contact information
Practice address
12255 DE PAUL DR STE 160, BRIDGETON, MO 63044-2513
(314) 291-8787
(314) 291-5804
Mailing address
12255 DE PAUL DR, BRIDGETON, MO 63044-2510
(314) 291-8787
(314) 291-5804
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32656
MO
Other
Enumeration date
09/26/2006
Last updated
08/22/2020
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