Individual
DR. STANLEY J BIRGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, STE 5C, SAINT LOUIS, MO 63110-1032
(314) 286-2700
(314) 286-2701
Mailing address
660 S EUCLID AVE, CB 8031, SAINT LOUIS, MO 63110-1010
(314) 286-2700
(314) 747-8856
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
29153
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200943314
—
MO
05
—
ENROLLED
—
IL
Enumeration date
07/18/2006
Last updated
07/19/2019
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