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General NPI Number Information
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NPI Number | 1699857151
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Entity Type | Individual
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Provider Name | MICHAEL A PATTERSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1501 PROFESSIONAL DR
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City | IMPERIAL
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State | MO
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Zip | 63052-3809
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Country | US
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Telephone | 636-547-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 660 MASON RIDGE CENTER DR STE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8512
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Country | US
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Telephone | 314-448-3791
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Fax | 314-483-3791
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 106797
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License Number State | MO
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