Individual
SUSAN J AMEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5631
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5631
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2009027331
MO
363A00000X
Physician Assistant
085.005841
IL
363A00000X
Physician Assistant
Primary
2009027331
MO
Other
Enumeration date
10/06/2009
Last updated
11/10/2020
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