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General NPI Number Information
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NPI Number | 1699848150
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Entity Type | Organization
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Legal Business Name | DANIEL J MESHOTO DO PC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 11110 LINDBERGH BUSINESS COURT
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City | ST. LOUIS
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State | MO
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Zip | 63123-7810
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Country | US
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Telephone | 314-845-8888
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Fax | 314-845-8833
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Provider Business Mailing Address
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Address Line | 11110 LINDBERGH BUSINESS COURT
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City | ST. LOUIS
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State | MO
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Zip | 63123-7810
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Country | US
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Telephone | 314-845-8888
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Fax | 314-845-8833
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Authorized Official
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Title or Position | PHYSICIAN - CEO
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Name | DR. DANIEL JOSEPH MESHOTO
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Credential | D.O.
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Telephone | 314-845-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO104006
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License Number State | MO
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