# ST ANN OB GYN INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063458305
- **Authorized official:** FRED R MONTERUBIO JR. MD (VP VICE PRESIDENT)
- **Authorized official phone:** (314) 432-2880

## Contact information

- **Practice address:** 3009 N BALLAS ROAD, SUITE 356C, ST LOUIS, MO 63131-2322
- **Practice address phone:** (314) 432-2880
- **Practice address fax:** (314) 432-4810
- **Mailing address:** 3009 N BALLAS ROAD, SUITE 356C, ST LOUIS, MO 63131-2322
- **Mailing address phone:** (314) 432-2880
- **Mailing address fax:** (314) 432-4810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2006
- **Last updated:** 08/22/2020