Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. George Randolphe Wettach, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1407077852

Dr. George Randolphe Wettach, MD is a Pathology in Saint Louis, Missouri. Qualified in 2006, 20 years ago. Practices with SSM Health Care Group, a 923-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
20
Licensed in
MO
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

425 S Euclid Ave Dept Pathology
Saint Louis, MO 63110-1005
Phone: (314) 362-5641
Fax: (314) 362-0369
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 2016007356 (MO)

Record details

NPI number1407077852
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 2, 2007
Last updated in NPPESNovember 15, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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