St Louis Medical Clinic, P.c.

NPI 1174505127 - Dermatology - 207N00000X

NPI Details
NPI 1174505127
Enumeration Date 11/16/2005
Last Updated 05/28/2009
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name DON DON
Position ADMINISTRATOR
Phone (314) 432-1111
Fax (314) 432-6308
Practice Location
3009 N BALLAS RD
SUITE 100B
SAINT LOUIS MO, 63131-2322, US
Phone (314) 432-1111
Fax (314) 432-6308
Business Location
PO BOX 11750
CLAYTON MO, 63105-0550, US
Phone (314) 432-1111
Fax (314) 432-6308
Toxanomy
Taxonomy Code 207N00000X
License State
License Number
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According to our database, St Louis Medical Clinic, P.c. NPI is 1174505127, taxonomy code is 207N00000X St Louis Medical Clinic, P.c. physically located at 3009 N Ballas Rd, Saint Louis MO, 63131-2322. NPI Number 1033115704 has the healthcare provider type.

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1174505127 NPI number is provided on an as is basis without warranty of any kind. 1174505127 is maintained by the National Plan & Provider Enumeration System. The contents of St Louis Medical Clinic, P.c. are for informational purposes only.