Organization
SSM DEPAUL MEDICAL GROUP
Active
Other names
SSM Orthopedics
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA L PULLUM (DIRECTOR)
(636) 669-2434
Entity
Organization
Contact information
Practice address
12266 DEPAUL DRIVE, SUITE 110, BRIDGETON, MO 63044-2514
(314) 291-7900
(314) 291-7914
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
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/14/2013
Last updated
09/16/2015
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