Organization
OLDE CABIN ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD B WEINSTOCK MD (MEDICAL DIRECTOR)
(314) 400-9999
Entity
Organization
Contact information
Practice address
11525 OLDE CABIN RD STE 101, CREVE COEUR, MO 63141-7146
(314) 400-9999
Mailing address
PO BOX 5393, CAROL STREAM, IL 60197-5393
(888) 337-3509
(941) 328-3997
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
10/29/2019
Last updated
07/01/2020
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