MEDICARE: DR. MARCIA CHRISTINE WILLING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	2009028907	MO
2	207SG0201X	Clinical Genetics (M.D.) Physician	2009028907	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457347577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCIA CHRISTINE WILLING MD

Provider Business Mailing Address
First Line	:	1 CHILDRENS PL
Second Line	:	MSC 8515-87-1200
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1002
Country	:	US
Telephone Number	:	314-454-6093
Fax Number	:	314-454-2075

Provider Business Practice Location Address
First Line	:	1 CHILDRENS PL
Second Line	:	DIV PED GENETICS & GENOMIC MED
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1002
Country	:	US
Telephone Number	:	314-454-6093
Fax Number	:	314-454-2075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	11/15/2021

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