Provider Demographics
NPI:1447278163
Name:WILLERS, DENISE MICHELLE SARVER (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:MICHELLE SARVER
Last Name:WILLERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-4211
Mailing Address - Fax:888-315-6494
Practice Address - Street 1:4901 FOREST PARK AVE
Practice Address - Street 2:DEPT OBGYN, STE 710
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1495
Practice Address - Country:US
Practice Address - Phone:314-362-4211
Practice Address - Fax:888-315-6494
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2004002779207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209077007Medicaid
MO209077007Medicaid
MO918940217Medicaid
MO918940217Medicare PIN