Healthcare Provider Details

I. General information

NPI: 1851120059
Provider Name (Legal Business Name): MIDWEST HAND SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11710 OLD BALLAS RD STE 110
SAINT LOUIS MO
63141-7076
US

IV. Provider business mailing address

1726 HORSESHOE RIDGE RD
CHESTERFIELD MO
63005-4418
US

V. Phone/Fax

Practice location:
  • Phone: 314-333-4263
  • Fax:
Mailing address:
  • Phone: 636-237-1474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW WINTERTON
Title or Position: OWNER
Credential: MD
Phone: 314-333-4263