Organization
ST. JOSEPH'S HEALTH CENTER WOMEN'S AND CHILDREN'S SERVICES CLINIC
Active
Other names
Physicians of SSM St. Louis
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE P. BARRY (NETWORK VICE PRESIDENT)
(314) 989-2180
Entity
Organization
Contact information
Practice address
600 MEDICAL DR, SUITE 209, WENTZVILLE, MO 63385-3426
(636) 332-8482
Mailing address
1836 LACKLAND HILL PKWY, ATTN CREDENTIALING DEPT, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2006023270
MO
207RP1001X
Pulmonary Disease Physician
Primary
2006023270
MO
Other
Enumeration date
02/05/2007
Last updated
10/17/2007
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