Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 2018014219 | MO |
NPI | 1013304948 |
---|---|
Provider Name | Dr. Ellen Hill Colgan |
First Address | Saint Louis, MO 63128-2250 |
Second Address | Saint Peters, MO 63376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 18/04/2019 |