Organization
SSM MEDICAL GROUP
Active
Other names
Family Practice of South County
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E BIESER (EXECUTIVE DIRECTOR)
(314) 822-5900
Entity
Organization
Contact information
Practice address
1011 BOWLES AVE, SUITE 300, FENTON, MO 63026-2387
(636) 496-5000
(636) 496-5055
Mailing address
10777 SUNSET OFFICE DR, SUITE 310, SAINT LOUIS, MO 63127-1019
(314) 822-5900
(314) 822-5919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/03/2008
Last updated
07/08/2009
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