DR. GEORGE RANDOLPHE WETTACH (NPI# 1407077852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407077852 |
| Entity Type | Individual |
| Full Name | DR. GEORGE RANDOLPHE WETTACH |
| Credential | MD |
| Practice Address |
425 S Euclid Ave Saint Louis MO 63110-1005 |
| Mailing Address |
660 S Euclid Ave C B 8118 Saint Louis MO 63110-1010 |
| Practice Telephone | 3142731884 |
| Practice Fax Number | 3143620369 |
| Mailing Telephone | 3142731884 |
| Mailing Fax Number | 3143620369 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2018-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
2016007356 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
425 S EUCLID AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255329058 | Jonathan W Heusel | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2005-10-06 |
| 1043662067 | Lulu Sun | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2016-07-02 |
| 1164842878 | Chieh-yu Lin | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2014-04-21 |
| 1417399676 | Kathleen Byrnes | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2013-07-29 |
| 1417399320 | Cody Weimholt | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2013-07-19 |
| 1528404696 | Deyali Chatterjee | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2013-05-16 |
| 1073958658 | Suzanne R Thibodeaux | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2013-05-08 |
| 1144562125 | Mena Mansour | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2013-03-18 |
| 1962690180 | Julie Ann Neidich | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2007-10-12 |
| 1245386226 | Steven L Larue | Pathology | 425 S Euclid Ave, Saint Louis, MO 63110-1005 | 2007-01-25 |
| Find all providers in the same location | ||||
| 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 Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609247543 | Muhammad Atif Atlaf Salyana | Pathology | 3635 Vista Ave Fl 4, Saint Louis University Hospital- Pathology Residency, Saint Louis, MO 63110-2539 | 2015-10-19 |
| 1194193326 | Mid-america Pathology Consultants, LLC | Pathology | 12898 Thornhill Ct, Saint Louis, MO 63131-1883 | 2015-09-03 |
| 1407260938 | Selvaraj Muthusamy | Pathology | 1325 S Grand Blvd, Room 436, Saint Louis, MO 63104-1018 | 2014-06-12 |
| 1184050031 | Rosa Perez Toro | Pathology | 350 Country Glen Ln, Saint Louis, MO 63141-6637 | 2013-09-24 |
| 1629326137 | Andrew Stephen Koopmeiners | Pathology | 660 So. Euclid, Box 8118, Washington University Department of Pathology, Saint Louis, MO 63108 | 2012-08-15 |
| 1912052416 | Mark Alan Hiken | Pathology | 9129 Wrenwood Ln, Saint Louis, MO 63144-1603 | 2007-01-24 |
| 1790849842 | John Todd Meredith | Pathology | 2040 Concourse Dr, Saint Louis, MO 63146-4119 | 2006-12-21 |
| 1255424974 | Jamie Cassity | Pathology | One Barnes-jewish Hospital Plaza, Saint Louis, MO 63110-1092 | 2006-10-02 |
| 1750315958 | Timothy D Fagen | Pathology | 1402 S Grand Blvd Ste M260, St Louis University Gme, Saint Louis, MO 63104-1004 | 2006-07-11 |
| 1316994726 | Sandra Faye Gibson | Pathology | 915 N Grand Blvd Pathology and Lab 113-jc, Va Medical Center, Saint Louis, MO 63106-1621 | 2006-05-30 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on DR. GEORGE RANDOLPHE WETTACH.
| 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.