Organization
ST ANN OB GYN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED R MONTERUBIO JR. MD (VP VICE PRESIDENT)
(314) 432-2880
Entity
Organization
Contact information
Practice address
3009 N BALLAS ROAD, SUITE 356C, ST LOUIS, MO 63131-2322
(314) 432-2880
(314) 432-4810
Mailing address
3009 N BALLAS ROAD, SUITE 356C, ST LOUIS, MO 63131-2322
(314) 432-2880
(314) 432-4810
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700216
MEDICARE COMPLETE
—
01
—
0700217
MEDICARE COMPLETE
—
01
—
100174
HEALTHLINK
—
01
—
101340
HEALTHLINK
—
01
—
112754
BLUE CROSS BLUE SHIELD
—
01
—
112759
BLUE CROSS BLUE SHIELD
—
01
—
3951
HEALTHCARE USA
—
01
—
4217036
AETNA
—
01
—
4270227
AETNA
—
01
—
45077
GROUP HEALTH PLAN
—
01
—
46319
GROUP HEALTH PLAN
—
01
—
5143
HEALTHCARE USA
—
01
—
SP15671
CIGNA
—
01
—
SP15678
CIGNA
—
Enumeration date
06/22/2006
Last updated
08/22/2020
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