Organization
SSM HEALTH CARE ST. LOUIS
Active
Parent organization
SSM HEALTHCARE ST. LOUIS
Other names
SSM Health St. Mary's Hospital Physician Billing
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTHCARE ST. LOUIS
Authorized official
MS. SHARON R. DUDLEY (EVP/COO)
(314) 768-8032
Entity
Organization
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8000
Mailing address
1145 CORPORATE LAKE DR, SAINT LOUIS, MO 63132-2907
(314) 989-6189
(314) 344-7281
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207U00000X
Nuclear Medicine Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3285
GHP GROUP NUMBER
MO
05
—
540326204
—
MO
Enumeration date
05/03/2006
Last updated
10/09/2020
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