Organization
SSM HEALTH CARE ST. LOUIS
Active
Other names
SSM Health DePaul Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN JOHNSON (PRESIDENT)
(314) 989-2072
Entity
Organization
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
(314) 344-6840
Mailing address
1145 CORPORATE LAKE DR, SAINT LOUIS, MO 63132-2907
(314) 989-2615
(314) 810-1399
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
540494101
—
MO
Enumeration date
05/24/2006
Last updated
02/14/2019
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