MICHAEL K WOLVERSON


Address: 3635 Vista Ave, Saint Louis, MO 63110-2539
Phone: 3142685783

MICHAEL K WOLVERSON (NPI# 1972523322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972523322
Entity Type Individual
Full Name MICHAEL K WOLVERSON
Credential MD
Practice Address 3635 Vista Ave
Saint Louis
MO 63110-2539
Mailing Address 3691 Rutger St
Provider Enrollment
Saint Louis
MO 63110-2515
Practice Telephone 3142685783
Practice Fax Number 3142685116
Mailing Telephone 3149774440
Enumeration Date 2006-07-20
Last Update Date 2008-03-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2085B0100X Radiology
Specialization: Body Imaging
R8237 MO Allopathic & Osteopathic Physicians
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
R8237 MO Allopathic & Osteopathic Physicians
N 2085U0001X Radiology
Specialization: Diagnostic Ultrasound
R8237 MO Allopathic & Osteopathic Physicians

Office Location

Street Address 3635 VISTA AVE
City SAINT LOUIS
State MO
Zip Code 63110-2539

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891790689 Rajeswari Chintapalli Anesthesiology 3635 Vista Ave, Saint Louis, MO 63110-2539 2005-06-17
1932711389 Breezy Summer Stanley Nurse Practitioner 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-08-18
1235756842 Trisha Ann Janis Nurse Practitioner 3635 Vista Ave, Saint Louis, MO 63110-2500 2020-06-30
1780207167 Michelle Reale Speech-Language Pathologist 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-20
1801418926 Jason Adam Horowitz Student in an Organized Health Care Education/Training Program 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-12
1255953378 Luke Andrew Momper Student in an Organized Health Care Education/Training Program 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-12
1063034197 Tyler Daniel Ragsdale Student in an Organized Health Care Education/Training Program 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-12
1417579541 Kelyn N Pittman Student in an Organized Health Care Education/Training Program 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-12
1881216901 Purav Sudhir Brahmbhatt Student in an Organized Health Care Education/Training Program 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-12
1578185989 Feras Kaid Radiologic Technologist 3635 Vista Ave, Saint Louis, MO 63110-2539 2020-05-08
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659971992 Carrie Ellen Smith Nurse Practitioner Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 2020-10-27
1881210466 Michelle Amanda Freilich Internal Medicine Barnes-jewish Plaza, St. Louis, MO 63110 2020-06-19
1245856046 Jeevin Shahi Radiology 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 2020-06-18
1497371314 Wilson Eduardo Rodriguez Student in an Organized Health Care Education/Training Program 1008 S. Spring, St Louis, MO 63110 2020-06-17
1578184065 Kathryn Kay Lindsay Registered Nurse Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 2020-05-06
1881232700 Ashley Diane Pace Nurse Practitioner 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 2019-12-11
1619520418 Krithika Damodar Shenoy Pathology 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 2019-07-20
1467912550 Ian Ferguson Dermatology 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 2019-03-23
1760978688 Ihab Hassanieh Student in an Organized Health Care Education/Training Program 33660 Vista Ave, St. Louis, MO 63110 2018-07-03
1336634500 Martin K Mwangi Pediatrics 1 Childrens Place, 3s34, St. Louis, M, MO 63110 2018-06-28
Find all providers in zip 63110

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609130566 Kristin Harris Drake Radiology 621 S New Ballas Rd Ste 23a, Saint Louis, MO 63141 2012-06-26
1093083016 William G Crawford Radiology 61 Crestwood Dr, Saint Louis, MO 63105-3020 2011-12-05
1558657643 Joseph Gary Livingston Radiology One Barnes-jewsih Hospital Plaza, Mailstop 90-09-355, Saint Louis, MO 63110 2011-06-27
1013219344 Pure Imaging LLC Radiology 12345 West Bend Drive, Saint Louis, MO 63128-2104 2010-11-18
1881884658 Zhengming Gu Radiology 9240 Radiom Dr, Saint Louis, MO 63123-5545 2007-07-27
1306057310 Mohammed Ali Abbas Radiology 1402 S Grand Blvd Rm 260, Saint Louis, MO 63104-1004 2007-05-24
1104040963 Saadoon Kadir Radiology 2909 Netherton Dr, Saint Louis, MO 63136-4677 2007-04-12
1376612739 Carl Joseph Aschkenasi Radiology 898 Alanson Dr, Saint Louis, MO 63132-5039 2006-11-07
1629182829 Jeffery A Hardy Radiology 2344 Hampton Ave, Saint Louis, MO 63139-2909 2006-08-18
1124132436 Alfred D Shaplin Radiology 1034 S Brentwood Blvd Ste 280, Saint Louis, MO 63117-1221 2006-08-17
Find all providers in SAINT LOUIS

Competitor

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City SAINT LOUIS
Zip Code 63110

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Dataset Information

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.

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