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Contact Information

GEORGE R WETTACH, MD
425 S EUCLID AVE
DEPT PATHOLOGY
SAINT LOUIS, MO63110-1005
 Phone: 314-362-5641
 Fax: 314-362-0369
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for GEORGE R WETTACH · (Male)

NPI Number 1407077852
Status Active
Credentials MD
Entity Individual
Enumeration date 05/02/2007
Last updated 11/15/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2016007356
  • MO Medicaid 200031776
Hospital affiliation(s)
  • SOUTHEAST MISSOURI HOSPITAL - (Acute Care)
    1701 LACEY ST
    CAPE GIRARDEAU, MO 63701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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