Individual
ALLEN D SOFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 N. NEW BALLAS RD., SUITE 270 WEST WING, ST. LOUIS, MO 63141
(314) 991-6969
(314) 997-6969
Mailing address
450 N. NEW BALLAS RD., SUITE 270 WEST WING, ST. LOUIS, MO 63141
(314) 991-6969
(314) 997-6969
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-079446
IL
207RC0000X
Cardiovascular Disease Physician
Primary
R5F98
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001012762
AREA 01 MEDICARE
MO
01
—
007013185
MEDICARE PROV ID AREA 99
MO
01
—
060041760
RR MEDICARE NUMBER
MO
01
—
1124011010
HHC CATH GROUP NPI
MO
01
—
1801889795
STL GROUP NPI
MO
01
—
1881863009
FARM GROUP NP
MO
01
—
CD6536
RR GROUP 01
MO
01
—
CI7050
RR GROUP 99
MO
Enumeration date
08/25/2005
Last updated
01/19/2016
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