Individual
JOHN PAUL SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3408
(636) 497-4000
(636) 497-4001
Mailing address
1520 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3408
(636) 497-4000
(636) 497-4001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018-00418
NC
207R00000X
Internal Medicine Physician
Primary
2019009766
MO
208000000X
Pediatrics Physician
2019009766
MO
Other
Enumeration date
03/31/2014
Last updated
02/12/2021
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