Unknown Individual – Internal Medicine Physician, NPI 1962557009
Internal Medicine Physician
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NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1836, Lackland Hill Parkway, Ascalon, Maryland Heights, Saint Louis County, Missouri, 63146, United States
ATTN CREDENTIALING DEPT
SAINT LOUIS, MO 631463572
Phone: (314) 989-0300
Type: Mailing
1224, Graham Road, Florissant, Saint Louis County, Missouri, 63031, United States
SUITE 117
FLORISSANT, MO 630318028
Phone: (314) 831-5553
Fax: (314) 831-6168
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63146)
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