Provider Demographics
NPI:1851334957
Name:AHLERING, GEORGE PHELAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PHELAN
Last Name:AHLERING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16216 BAXTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4770
Mailing Address - Country:US
Mailing Address - Phone:636-449-4700
Mailing Address - Fax:636-449-2596
Practice Address - Street 1:16216 BAXTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4770
Practice Address - Country:US
Practice Address - Phone:636-449-4700
Practice Address - Fax:636-449-2596
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2D12207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA2119293OtherD E A NUMBER
MOR2D12OtherMEDICAL LICENSE,PHYS&SURG
MO26134OtherB N D D NUMBER
869736OtherA B O G
AA2119293OtherD E A NUMBER