Organization
SSM MEDICAL GROUP INC.
Active
Other names
SSM Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET EDER (PROVIDER ENROLLMENT SPECIALIST)
(636) 498-5944
Entity
Organization
Contact information
Practice address
12255 DEPAUL DRIVE, SUITE 120, BRIDGETON, MO 63044
(314) 291-7900
Mailing address
3221 MCKELVEY RD STE 301, BRIDGETON, MO 63044-2551
(636) 498-5944
(314) 209-8127
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
10/19/2018
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