Organization
PAUL M. PACKMAN INC.
Active
Organization
PAUL M. PACKMAN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MICHAEL PACKMAN M.D. (PRESIDENT)
(314) 727-1666
Entity
Organization
Contact information
Practice address
8301 MARYLAND AVE., SUITE 320, ST. LOUIS, MO 63105
(314) 727-1666
(314) 727-5488
Mailing address
8301 MARYLAND AVE, SUITE 320, ST. LOUIS, MO 63105
(314) 727-1666
(314) 727-5488
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
29193
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000005191
MO MEDICARE SERVICES
MO
05
—
200743300
—
MO
01
—
826262307
RAILROAD MEDICARE
MO
Enumeration date
09/26/2008
Last updated
09/26/2008
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