MR. MICHAEL E MIMLITZ (NPI# 1508891870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508891870 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL E MIMLITZ |
| Credential | MD |
| Practice Address |
1062 Old Des Peres Rd Saint Louis MO 63131-1865 |
| Practice Telephone | 3143941660 |
| Practice Fax Number | 3143941663 |
| Mailing Telephone | 3143941660 |
| Mailing Fax Number | 3143941663 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2018-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 2017006602 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BCBS | 105971 | 01 |
| MO | UHC | 0700441 | 01 |
| MO | 208179317 | 05 |
| Street Address |
1062 OLD DES PERES RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63131-1865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275019408 | Men's Medical Institute LLC | Clinic/Center | 1062 Old Des Peres Rd, Saint Louis, MO 63131-1865 | 2018-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097954 | Avalcare Inc | Pharmacy | 10431 Clayton Rd, Saint Louis, MO 63131 | 2020-03-06 |
| 1891331369 | Life Clinic of Mo Dc PC | Chiropractor | 2051 South Lindbergh Blvd, Frontenac, MO 63131 | 2019-11-20 |
| 1447892542 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 30 S Lindbergh Blvd, Saint Louis, MO 63131 | 2019-10-10 |
| 1336797026 | Justa Davis | Dietitian, Registered | 3015 North Ballas, Saint Louis, MO 63131 | 2019-08-27 |
| 1730695362 | Curators of The University of Missouri | Psychologist | 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 | 2017-12-19 |
| 1770012031 | Danielle Marie Hargate | Specialist/Technologist | 732 Timber Trail, Frontenac, MO 63131 | 2017-06-08 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1437524360 | Julie Ann Godefroid | Nurse Practitioner | 1010 Old Des Peres Road, St. Louis, MO 63131 | 2015-12-03 |
| 1073982435 | Rebecca Baum Rainbolt | Social Worker | 12210 Clayton Rd, Saint Louis, MO 63131 | 2015-09-16 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| Find all providers in zip 63131 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568984367 | Gsh Lab LLC | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 1017b, Saint Louis, MO 63141-8264 | 2017-07-13 |
| 1851825715 | Sydni Fazenbaker Crowell | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 2009b, Saint Louis, MO 63141 | 2017-04-18 |
| 1962865170 | Zachary Keller | Obstetrics & Gynecology | 621 S New Ballas Rd Ste 499a, Saint Louis, MO 63141-8260 | 2016-04-04 |
| 1174985154 | Leah Hong | Obstetrics & Gynecology | 6420 Clayton Rd Ste 2800, Saint Louis, MO 63117-1811 | 2016-03-28 |
| 1972997088 | Jennifer E Powel | Obstetrics & Gynecology | 6420 Clayton Rd Ste 230-a, Saint Louis, MO 63117-1811 | 2015-03-26 |
| 1386068864 | Wcc 2, LLC | Obstetrics & Gynecology | 3023 N Ballas Rd Bldg D, Suite 120d, Saint Louis, MO 63131-2330 | 2014-02-05 |
| 1881987410 | Herman Taute | Obstetrics & Gynecology | 12040 Heatherdane Dr, Saint Louis, MO 63131-3119 | 2011-05-16 |
| 1174828198 | Frank Eugene Hunleth | Obstetrics & Gynecology | 5331 Donovan Ave, Saint Louis, MO 63109-2635 | 2011-01-22 |
| 1972804631 | Anastasios K Dagartzikas | Obstetrics & Gynecology | 12902 Tundra Ct, Saint Louis, MO 63131-1319 | 2010-11-11 |
| 1811227390 | Laurel D Fendrich | Obstetrics & Gynecology | 10010 Kennerly Rd Fl 4, Saint Louis, MO 63128 | 2010-01-06 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63131 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.