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General NPI Number Information
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NPI Number | 1043896996
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Entity Type | Organization
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Legal Business Name | METRO EAST ORTHOPEDICS, PLLC
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 14825 N OUTER 40 RD STE 310
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2152
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Country | US
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Telephone | 314-392-5029
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Fax | 314-392-5086
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Provider Business Mailing Address
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Address Line | 14825 N OUTER 40 RD STE 310
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2152
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Country | US
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Telephone | 314-392-5029
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Fax | 314-392-5086
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ASHLEY GARDNER
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Credential |
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Telephone | 314-392-5029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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