Fenton Emergency Group Llc

NPI 1770832792 - Physician Assistant - 363A00000X

NPI Details
NPI 1770832792
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
1015 BOWLES AVE
FENTON MO, 63026-2394, 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, Fenton Emergency Group Llc NPI is 1770832792, taxonomy code is 363A00000X Fenton Emergency Group Llc physically located at 1015 Bowles Ave, Fenton MO, 63026-2394. NPI Number 1033115704 has the healthcare provider type.

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1770832792 NPI number is provided on an as is basis without warranty of any kind. 1770832792 is maintained by the National Plan & Provider Enumeration System. The contents of Fenton Emergency Group Llc are for informational purposes only.