NPI 1508066317 · live from the CMS NPI Registry
Terra Rupert Blatnik, MD
Pediatrics, Sports Medicine in Saint Louis, MO. National Provider Identifier 1508066317, active.
NPI record
| NPI | 1508066317 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Sports Medicine 2080S0010X |
| Practice location | 4921 Parkview Pl, Dept Orthopaedic Surgery, Ste 6a/6b/12a, Saint Louis, MO 63110 |
| Practice phone | 314-514-3500 |
| Mailing address | Po Box 7412011, Chicago, IL 60674 |
| Enumerated | July 19, 2007 |
| Last updated | October 9, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Sports Medicine primary | 2080S0010X | 2015013430 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.