Individual
MILTON SALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
378 DINSMOOR DR, CHESTERFIELD, CHESTERFIELD, MO 63017-2956
(314) 583-9142
Mailing address
378 DINSMOOR DR, CHESTERFIELD, CHESTERFIELD, MO 63017-2956
(314) 583-9142
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-109941
IL
207P00000X
Emergency Medicine Physician
Primary
2002020415
MO
207R00000X
Internal Medicine Physician
020415
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207673005
—
MO
05
—
207673013
—
MO
05
—
207673021
—
MO
Enumeration date
09/16/2005
Last updated
11/20/2019
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