Organization
NEURO-STATUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT WARMOUTH M.D. (CO-PRESIDENT)
(314) 325-4931
Entity
Organization
Contact information
Practice address
40 BURROUGHS LN, SAINT LOUIS, MO 63124-1857
(314) 325-4931
Mailing address
40 BURROUGHS LN, SAINT LOUIS, MO 63124-1857
(314) 325-4931
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
08/30/2016
Last updated
12/22/2016
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