Organization
ST. CHARLES COUNTY CARDIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TABER MD (PHYSICIAN)
(636) 947-5000
Entity
Organization
Contact information
Practice address
300 1ST CAPITOL DR, SAINT CHARLES, MO 63301-2844
(636) 947-5000
Mailing address
1836 LACKLAND HILL PKWY, ATTNT CREDENTIALING DEPT, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
R9F84
MO
Other
Enumeration date
02/02/2007
Last updated
08/22/2020
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