Organization
STELLA MARIS INTERNAL MEDICINE LLC
Active
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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