Basic Information
Provider Information
NPI: 1083868400
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUELLER
FirstName: MEGAN
MiddleName: D
NamePrefix: MRS.
NameSuffix:  
Credential: A.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DOWDY
OtherFirstName: MEGAN
OtherMiddleName:  
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 339 CONSORT DR
Address2:  
City: BALLWIN
State: MO
PostalCode: 630114439
CountryCode: US
TelephoneNumber: 6363869224
FaxNumber: 6362004243
Practice Location
Address1: 615 S NEW BALLAS RD
Address2: DEPT. OF ANESTHESIA
City: SAINT LOUIS
State: MO
PostalCode: 631418221
CountryCode: US
TelephoneNumber: 6363869224
FaxNumber: 6362004243
Other Information
ProviderEnumerationDate: 11/12/2008
LastUpdateDate: 11/12/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X2008028842MOY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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