Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2010013490 | MO |
N | 207R00000X | Internist | 2010013490 | MO |
N | 111NI0900X | Internist | 2010013490 | MO |
NPI | 1124235239 |
---|---|
Provider Name | Dr. Jeremy Shawn Katcher |
First Address | Saint Louis, MO 63156-3340 |
Second Address | Saint Louis, MO 63128-2945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 09/07/2020 |