MEDICARE: CAROLINE WERNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	R1F05	MO

General Provider Information

NPI Number	:	1538151097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE WERNER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 955534
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-5534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 SHACKELFORD RD
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-4369
Country	:	US
Telephone Number	:	314-921-4420
Fax Number	:	314-921-6086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	03/19/2021

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