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General NPI Number Information
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NPI Number | 1649704784
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Entity Type | Individual
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Provider Name | MEGAN OTTOMEYER D.O
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Gender | Female
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Dates
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Enumeration Date | 04/15/2017
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 1465 S GRAND BLVD SUITE 2717
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1003
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Country | US
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Telephone | 314-577-5634
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Fax | 314-577-5616
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Provider Business Mailing Address
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Address Line | 1465 S GRAND BLVD SUITE 2717
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1003
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Country | US
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Telephone | 314-617-2712
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Fax | 314-617-2679
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 2020019648
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License Number State | MO
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