Organization
ST. ANTHONY'S PHYSICIAN ORGANIZATION
Active
Other names
Mercy Clinic South Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL MATEJKA (CFO EAST COMMUNITIES & SFO)
(314) 251-1958
Entity
Organization
Contact information
Practice address
10012 KENNERLY RD, SUITE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
(314) 543-5994
Mailing address
10012 KENNERLY RD, SUITE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
(314) 543-5994
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015644
MEDICARE PTAN
MO
Enumeration date
01/15/2014
Last updated
01/04/2019
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