Botteron, Gregory W
Botteron, Gregory W is an individual health care provider with primary practice located at 10012 Kennerly Rd Suite 202, Saint Louis MO 63128-2197. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Botteron, Gregory W can be contacted via phone (314) 692-2807.Contact Information
Primary practice address
10012 Kennerly Rd Suite 202
Saint Louis MO 63128-2197
Phone: (314) 692-2807
Fax: (314) 991-0727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | MDR2P81 | Missouri |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | R2P81 | Missouri |
Profile Details
| NPI number | 1215933106 |
|---|---|
| LBN Legal business name | Botteron, Gregory W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Aug 8th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215933106 | NPPES |
| Missouri | MEDICAID | 208687814 |
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