Organization
SSM DEPAUL MEDICAL GROUP, INC.
Active
Other names
DePaul Medical Group Neurosurgery
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA PULLUM (DIRECTOR OF PATIENT ACCOUNTS)
(314) 209-8121
Entity
Organization
Contact information
Practice address
12255 DE PAUL DR, SUITE 830, BRIDGETON, MO 63044-2510
(314) 291-6556
Mailing address
12255 DE PAUL DR, SUITE 830, BRIDGETON, MO 63044-2510
(314) 291-6556
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
08/16/2006
Last updated
08/22/2020
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