Provider Demographics
NPI:1699732313
Name:CARNS, WENDI M (MD)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:M
Last Name:CARNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 MID AMERICA LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1202
Mailing Address - Country:US
Mailing Address - Phone:636-717-1390
Mailing Address - Fax:636-717-1395
Practice Address - Street 1:4280 MID AMERICA LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129
Practice Address - Country:US
Practice Address - Phone:636-717-1390
Practice Address - Fax:636-717-1395
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004001934207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208369801Medicaid
MOIO7882Medicare UPIN
MO208369801Medicaid