Organization
SSM DEPAUL MEDICAL GROUP, INC.
Active
Other names
SSM Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA PULLUM (BILLING MANAGER)
(636) 669-2434
Entity
Organization
Contact information
Practice address
2305 GEORGIA ST, LOUISIANA, MO 63353-2559
(314) 291-0846
(573) 754-6056
Mailing address
1551 WALL ST, SUITE 310, SAINT CHARLES, MO 63303-3539
(636) 669-2268
(314) 209-8127
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
01/15/2016
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