Healthcare Provider Details

I. General information

NPI: 1184003410
Provider Name (Legal Business Name): EMILY WHITAKER ZANTOW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS EMILY SUSAN WHITAKER

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S NEW BALLAS RD STE 2007B
SAINT LOUIS MO
63141-8265
US

IV. Provider business mailing address

621 S NEW BALLAS RD STE 2007B
SAINT LOUIS MO
63141-8265
US

V. Phone/Fax

Practice location:
  • Phone: 314-991-5000
  • Fax:
Mailing address:
  • Phone: 314-991-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number2020012681
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2020012681
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: