Organization
ST CLAIR ALLERGY-ASTHMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D. MARCUM M.D. (PRESIDENT)
(636) 629-6030
Entity
Organization
Contact information
Practice address
1020 ST. CLAIR PLAZA, ST. CLAIR, MO 63077
(636) 629-6030
(636) 629-6030
Mailing address
13025 PAGADA PKWY, SAINT LOUIS, MO 63127-1931
(636) 629-6030
(636) 629-6030
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R3G15
MO
Other
Enumeration date
12/18/2009
Last updated
07/25/2014
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