Healthcare Provider Details

I. General information

NPI: 1841618337
Provider Name (Legal Business Name): MEREDITH METCALF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 04/17/2025
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 FOREST PARK AVE DIV SURG UROLOGY, 5TH FL
SAINT LOUIS MO
63108-2114
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-8200
  • Fax: 888-425-8245
Mailing address:
  • Phone: 314-362-8200
  • Fax: 888-425-8245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2024012929
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: