Provider Demographics
NPI:1538263140
Name:FERGUSON, WILLIAM S (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1465 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1003
Mailing Address - Country:US
Mailing Address - Phone:314-577-5638
Mailing Address - Fax:314-268-4081
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-577-5638
Practice Address - Fax:314-268-4081
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2021-01-11
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Provider Licenses
StateLicense IDTaxonomies
MO20040066642080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology