Healthcare Provider Details

I. General information

NPI: 1720129489
Provider Name (Legal Business Name): SHARON ANNE GODAR MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 STUDT AVE
SAINT LOUIS MO
63141-7031
US

IV. Provider business mailing address

40 BAXTER LN
CHESTERFIELD MO
63017-4900
US

V. Phone/Fax

Practice location:
  • Phone: 314-989-9199
  • Fax: 314-989-9491
Mailing address:
  • Phone: 636-537-3750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberR1C88
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: