| Dr David Andrew Wathen, DO | |
|
1465 S Grand Blvd, St. Louis, MO 63104-1003 | |
| (314) 577-1607 | |
| (314) 268-4112 |
| Full Name | Dr David Andrew Wathen |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1465 S Grand Blvd, St. Louis, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811190408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 2009008973 (Missouri) | Secondary |
| 208000000X | Pediatrics | 2009008973 (Missouri) | Primary |
| Entity Name | Mercy Hospitals East Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851431738 PECOS PAC ID: 1658276811 Enrollment ID: O20031218000107 |
| Entity Name | Ssm Health Care Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306589544 PECOS PAC ID: 0143608372 Enrollment ID: O20220531002655 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Andrew Wathen, DO 1465 S Grand Blvd, Saint Louis, MO 63104-1003 Ph: (314) 577-1607 | Dr David Andrew Wathen, DO 1465 S Grand Blvd, St. Louis, MO 63104-1003 Ph: (314) 577-1607 |
Patrick Francis Durkin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Place, 3rd Floor, Suite 3s34, St. Louis, MO 63110 Phone: 314-454-6006 | |
Shulamit Menashe Portnoy, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1465 S Grand Blvd, St. Louis, MO 63104 Phone: 314-577-5609 Fax: 314-268-4028 | |
Felicia L. Harvey, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 11642 West Florissant, St. Louis, MO 63033 Phone: 314-838-8220 Fax: 314-838-8091 | |
Mary S Heaney, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1465 S Grand Blvd, St. Louis, MO 63104 Phone: 314-268-4101 Fax: 314-577-5379 | |
Dr. Kristen M Mennemeier, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3009 N. Ballas Rd., Suite 257c, St. Louis, MO 63131 Phone: 314-569-2112 Fax: 314-569-1270 | |
Lauren Marie Hayes, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1465 South Grand Boulevard, Room 1204, Ssm Cardinal Glennon Children's Medical Center, St. Louis, MO 63104 Phone: 314-577-5600 Fax: 314-577-5616 | |
Carine Rafic Anka, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Childrens Pl Msc 8116-0043-10, St. Louis, MO 63110 Phone: 314-454-6051 Fax: 314-454-6225 |