Provider Demographics
NPI:1689054553
Name:GROTE, CALEB W (MD)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:W
Last Name:GROTE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8233
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-514-3500
Mailing Address - Fax:314-747-2598
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:STE 1B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6062
Practice Address - Fax:314-454-5054
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2020-09-02
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Provider Licenses
StateLicense IDTaxonomies
MO2020013859207XP3100X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200048943Medicaid
ILENROLLEDMedicaid