Organization
PRACTICE OF ALAN SPIVACK, LLC
Active
Parent organization
ST. LUKE'S MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. LUKE'S MEDICAL GROUP
Authorized official
RICK SONNE (DIRECTOR)
(314) 576-2490
Entity
Organization
Contact information
Practice address
224 S WOODS MILL RD, SUITE 620, CHESTERFIELD, MO 63017-3451
(314) 576-1610
(314) 576-1859
Mailing address
232 S WOODS MILL RD, ATTN: RICK SONNE, CHESTERFIELD, MO 63017-3417
(314) 576-2490
(314) 576-2473
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29603
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1121155230
RAILROAD MEDICARE
MO
Enumeration date
10/06/2006
Last updated
10/31/2007
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