Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2019031079 | MO |
NPI | 1710326467 |
---|---|
Provider Name | Dr. Megan Alexis Walters |
First Address | Saint Louis, MO 63110-2539 |
Second Address | Saint Louis, MO 63104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 08/10/2019 |