Provider Demographics
NPI:1184003410
Name:ZANTOW, EMILY WHITAKER (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:WHITAKER
Last Name:ZANTOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:SUSAN
Other - Last Name:WHITAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD STE 2007B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8265
Mailing Address - Country:US
Mailing Address - Phone:314-991-5000
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD STE 2007B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8265
Practice Address - Country:US
Practice Address - Phone:314-991-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020012681207V00000X, 207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program