Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2008017830 | MO |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2012017154 | MO |
NPI | 1225291636 |
---|---|
Provider Name | Dr. Jennifer Goldkamp |
First Address | Saint Louis, MO 63117-1858 |
Second Address | Saint Louis, MO 63117-1858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 05/11/2020 |