Organization
PRACTICE MANAGEMENT AFFILIATES CONSULTING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HALL (ADMINISTRATOR)
(636) 939-4200
Entity
Organization
Contact information
Practice address
1600 HERITAGE LNDG, SUITE 215, SAINT PETERS, MO 63303-8489
(636) 939-4200
(636) 939-4204
Mailing address
1600 HERITAGE LNDG, SUITE 215, SAINT PETERS, MO 63303-8489
(636) 939-4200
(636) 939-4204
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505843003
—
MO
Enumeration date
07/04/2006
Last updated
03/05/2020
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