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NPI Code Detail

MEDICARE: DR. CARL GRIFFIN TROTTER M.D.

MEDICARE:  DR. CARL GRIFFIN TROTTER  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
1207P00000XEmergency Medicine Physician111798MO

General Provider Information

NPI Number : 1689060840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL GRIFFIN TROTTER M.D.
Provider Business Mailing Address
First Line : 3545 LAFAYETTE AVE
Second Line : SALUS BUILDING ROOM 501
City : SAINT LOUIS
State : MO
Zip : 63104-1314
Country : US
Telephone Number : 314-977-6665
Fax Number : 314-977-5150
Provider Business Practice Location Address
First Line : 3545 LAFAYETTE AVE
Second Line : SALUS BUILDING ROOM 501
City : SAINT LOUIS
State : MO
Zip : 63104-1314
Country : US
Telephone Number : 314-977-6665
Fax Number : 314-977-5150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2015
Last Update Date : 04/14/2015

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