=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649294752
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WARREN RALPH TRAMPE DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2006
-----------------------------------------------------
Last Update Date | 10/13/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2917 HIGHWAY K SUITE G
-----------------------------------------------------
City | O FALLON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63368-7979
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-240-1127
-----------------------------------------------------
Fax | 636-240-0041
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2917 HIGHWAY K SUITE G
-----------------------------------------------------
City | O FALLON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63368-7979
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-240-1127
-----------------------------------------------------
Fax | 636-240-0041
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 000794
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------