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Organization

ST LOUIS MEDICAL PROFESSIONALS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NEEVEEN SALAMA (BILLING)
(314) 543-2800
Entity
Organization

Contact information

Practice address
8790 WATSON RD, SUITE 201, SAINT LOUIS, MO 63119-5140
(314) 543-2800
(314) 543-2801
Mailing address
8790 WATSON RD, SUITE 201, SAINT LOUIS, MO 63119-5140
(314) 543-2800
(314) 543-2801

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RI0200X
Infectious Disease Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
133658
BLUE CROSS BLUE SHIELD
MO
05
507345502
MO
01
62328300001
DMEPTAN
MO
01
CJ3494
MEIDCARE RAILROAD
MO
Enumeration date
10/18/2006
Last updated
06/26/2024
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