Organization
SSM MEDICAL GROUP
Active
Other names
Suburban West Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E BIESER (EXECUTIVE DIRECTOR)
(314) 822-5900
Entity
Organization
Contact information
Practice address
1011 BOWLES AVE, SUITE 300, FENTON, MO 63026-2387
(636) 496-5000
(636) 496-5045
Mailing address
1011 BOWLES AVE, SUITE 300, FENTON, MO 63026-2387
(636) 496-5000
(636) 496-5045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/20/2007
Last updated
07/08/2009
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