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Organization

ST LOUIS GYNECOLOGY & ONCOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAA A ELBENDARY M.D. (MANAGING MEMBER)
(314) 991-5445
Entity
Organization

Contact information

Practice address
11652 STUDT AVE, SAINT LOUIS, MO 63141-7025
(314) 991-5445
(314) 991-5447
Mailing address
11652 STUDT AVE, SAINT LOUIS, MO 63141-7025
(314) 991-5445
(314) 991-5447

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
110171
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
027213
FMH EXCLUSIVE CHOICE
01
121918
GROUP HEALTH PLAN
01
288803
HEALTHLINK
01
33180
BLUE CHOICE
MO
01
33810
BCBS
MO
01
352689215
TRICARE
01
797098
MEDICARE COMPLETE
MO
01
DE9886
RR MEDICARE
MO
01
F82867
MERCY
Enumeration date
08/11/2006
Last updated
12/03/2010
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