# SSM ST. CHARLES CLINIC MEDICAL GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** SSM Health Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578670949
- **Authorized official:** MS. LAURA PULLUM (BILLING MANAGER)
- **Authorized official phone:** (636) 669-2434

## Contact information

- **Practice address:** 722 N HIGHWAY 47, SUITE B, WARRENTON, MO 63383-1108
- **Practice address phone:** (636) 456-3413
- **Practice address fax:** (636) 669-2401
- **Mailing address:** 1551 WALL ST, SUITE 310, SAINT CHARLES, MO 63303-3539
- **Mailing address phone:** (636) 669-2268
- **Mailing address fax:** (314) 209-8127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 01/15/2016