Organization
GENERATIONS FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA A BAXTER M.D. (PRESIDENT)
(314) 781-4922
Entity
Organization
Contact information
Practice address
1035 BELLEVUE AVE, SUITE 206, ST LOUIS, MO 63117-1846
(314) 781-4922
(314) 645-0158
Mailing address
1035 BELLEVUE AVE, SUITE 206, ST LOUIS, MO 63117-1846
(314) 781-4922
(314) 645-0158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000154561
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509156709
—
MO
Enumeration date
07/04/2006
Last updated
12/13/2011
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