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Contact Information

DEVIN R WILLIS, MD
16555 MANCHESTER RD STE 100
WILDWOOD, MO63040
 Phone: 636-458-0646
 Fax: 636-458-5008
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
 

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for DEVIN R WILLIS · (Male)

NPI Number 1295175057
Status Active
Credentials MD
Entity Individual
Enumeration date 06/26/2013
Last updated 11/10/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2016023372
Hospital affiliation(s)
  • MERCY HOSPITAL ST LOUIS - (Acute Care)
    615 NEW BALLAS ROAD
    SAINT LOUIS, MO 63141
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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