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Organization
SSM ST. CHARLES CLINIC MEDICAL GROUP, INC.
Active
Organization
SSM ST. CHARLES CLINIC MEDICAL GROUP, INC.
Active
Other names
SSM Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA PULLUM (BILLING MANAGER)
(636) 669-2434
Entity
Organization
Contact information
Practice address
722 N HIGHWAY 47, SUITE B, WARRENTON, MO 63383-1108
(636) 456-3413
(636) 669-2401
Mailing address
1551 WALL ST, SUITE 310, SAINT CHARLES, MO 63303-3539
(636) 669-2268
(314) 209-8127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
01/15/2016
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