Organization
ST LOUIS PATHOLOGY ASSOC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW DRAKE POESCHL MD (PRESIDENT)
(314) 251-1884
Entity
Organization
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141
(314) 251-1884
Mailing address
PO BOX 20452, COLUMBUS, OH 43220-0452
(614) 457-8180
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010864
MEDICARE PTAN
MO
05
—
501888903
—
MO
Enumeration date
05/18/2006
Last updated
07/10/2019
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