Unknown Individual – Pediatrics Physician, NPI 1356416754
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
777 SO NEW BALLAS ROAD
SUITE 223W
ST LOUIS, MO 63141
Phone: (314) 567-9190
Fax: (314) 567-9190
Type: Mailing
777, South New Ballas Road, Town and Country, Saint Louis County, Missouri, 63141, United States
SUITE 223W
ST LOUIS, MO 63141
Phone: (314) 567-9190
Fax: (314) 567-9191
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)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63141)
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