=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407872625
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYRENE D GROTHAUS-DAY MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 09/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1378 MOSSWOODS DR
-----------------------------------------------------
City | FENTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63026-7226
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-861-1676
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 335 DAVIS DR
-----------------------------------------------------
City | HOLTS SUMMIT
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65043-2135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-320-2958
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP3000X
-----------------------------------------------------
Taxonomy Name | Pediatric Anesthesiology Physician
-----------------------------------------------------
License Number | 2003019558
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207LP3000X
-----------------------------------------------------
Taxonomy Name | Pediatric Anesthesiology Physician
-----------------------------------------------------
License Number | 036-126419
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------