Bridgeton Emergency Group Llc

NPI 1053660076 - Physician Assistant - 363A00000X

NPI Details
NPI 1053660076
Enumeration Date 09/05/2012
Last Updated 01/14/2016
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name LISHA C LISHA
Position VP OF CONTRACTING
Phone (800) 893-9698
Fax
Practice Location
12303 DE PAUL DR
BRIDGETON MO, 63044-2512, US
Phone (800) 893-9698
Fax
Business Location
200 CORPORATE BLVD
LAFAYETTE LA, 70508-3870, US
Phone (337) 354-1153
Fax
Toxanomy
Taxonomy Code 363A00000X
License State
License Number
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According to our database, Bridgeton Emergency Group Llc NPI is 1053660076, taxonomy code is 363A00000X Bridgeton Emergency Group Llc physically located at 12303 De Paul Dr, Bridgeton MO, 63044-2512. NPI Number 1033115704 has the healthcare provider type.

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1053660076 NPI number is provided on an as is basis without warranty of any kind. 1053660076 is maintained by the National Plan & Provider Enumeration System. The contents of Bridgeton Emergency Group Llc are for informational purposes only.