Organization
ST LOUIS MEDICAL CLINIC, P.C.
Active
Other names
St. Louis Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MINDY D POWELL (ADMINISTRATOR)
(314) 983-4000
Entity
Organization
Contact information
Practice address
3009 N BALLAS RD, SUITE 100B, SAINT LOUIS, MO 63131-2322
(314) 432-1111
(314) 432-6308
Mailing address
PO BOX 778969, CHICAGO, IL 60677-0001
(314) 432-1111
(314) 432-6308
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
213E00000X
Podiatrist
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D2302743
CLIA
MO
Enumeration date
11/16/2005
Last updated
04/30/2026
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