Healthcare Provider Details

I. General information

NPI: 1730202029
Provider Name (Legal Business Name): JOHN SUTTON WELCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 11/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL DIV IM BONE MARROW TRANSPLANT, 7TH FL
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

660 S EUCLID AVE CB 8056
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-8339
  • Fax: 314-454-5656
Mailing address:
  • Phone: 314-454-8339
  • Fax: 314-454-5656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2007001652
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: