Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2016011494 | MO |
N | 2080P0202X | Pediatric Cardiologist | DR.0058340 | CO |
NPI | 1134562937 |
---|---|
Provider Name | Melissa Ann Wehrmann |
First Address | Saint Louis, MO 63104-1003 |
Second Address | Saint Louis, MO 63104-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2013 |
Last Update Date | 11/04/2017 |