Organization · Type 2 NPI
Ear Nose Throat Medical Service
Otolaryngology/Facial Plastic Surgery Physician · Chesterfield, MO
NPI number
1407490105
Active
Practice location
226 S Woods Mill Rd Ste 44W
Chesterfield, MO 63017-3442
Fax (314) 682-6093
Mailing address
1324 Clarkson Clayton Ctr Ste 301
Ellisville, MO 63011-2145
Other practice locations
- 4800 Mexico Rd Ste 103, St. Peters, MO 63376-1666 · (636) 936-5002
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician Primary | 207YX0905X | None listed |
Otolaryngology/Facial Plastic Surgery Physician: An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Another provider at this address
Other otolaryngology/facial plastic surgery physician providers in Chesterfield
About NPI 1407490105
Ear Nose Throat Medical Service's National Provider Identifier is 1407490105, issued on Nov 5, 2019. The primary taxonomy on file is Otolaryngology/Facial Plastic Surgery Physician (207YX0905X), and the practice location is in Chesterfield, MO. The record was last updated on Oct 3, 2022.