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Contact Information

GREGORY W BOTTERON, MD
4280 MID AMERICA LN STE 10
SAINT LOUIS, MO63129-1202
 Phone: 314-842-0602
 Fax: 314-842-4372
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Cardiac Electrophysiology

207RC0001X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GREGORY W BOTTERON · (Male)

NPI Number 1215933106
Status Active
Credentials MD
Entity Individual
Enumeration date 06/24/2005
Last updated 02/10/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MO License # MDR2P81
  • MO License # R2P81
  • MO Medicaid 208687814
Hospital affiliation(s)
  • BOONE HOSPITAL CENTER - (Acute Care)
    1600 E BROADWAY
    COLUMBIA, MO 65201
  • ST ANTHONY'S MEDICAL CENTER - (Acute Care)
    10010 KENNERLY ROAD
    SAINT LOUIS, MO 63128
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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