Organization
STELLA MARIS INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANI CHARLES SOUDAH MD, PHD (DOCTOR)
(314) 205-1926
Entity
Organization
Contact information
Practice address
12855 N 40 DR, SUITE 350, SAINT LOUIS, MO 63141-8635
(314) 205-1926
(314) 205-1076
Mailing address
12855 N 40 DR, SUITE 350, SAINT LOUIS, MO 63141-8635
(314) 205-1926
(314) 205-1076
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
103060
MO
Other
Enumeration date
06/03/2006
Last updated
03/17/2014
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