Unknown Individual – Surgery Physician, NPI 1790736171
Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
3535 SOUTH JEFFERSON STE 101
STE 101
ST LOUIS, MO 63111
Phone: (314) 771-7677
Fax: (314) 773-7962
Type: Location
11758, Westham Drive, Radcliffe, Town and Country, Saint Louis County, Missouri, 63131, United States
SAINT LOUIS, MO 631312538
Phone: (314) 432-2491
Type: Mailing
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 63111)
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