Healthcare Provider Details

I. General information

NPI: 1386971943
Provider Name (Legal Business Name): MEREDITH THROOP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 LINDELL BLVD
SAINT LOUIS MO
63108-2914
US

IV. Provider business mailing address

4130 LINDELL BLVD
SAINT LOUIS MO
63108-2914
US

V. Phone/Fax

Practice location:
  • Phone: 314-535-5600
  • Fax:
Mailing address:
  • Phone: 314-535-5600
  • Fax: 314-535-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2014034661
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: