Individual
PAULA Y GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-5555
(314) 257-5556
Mailing address
3691 RUTGER ST, SAINT LOUIS, MO 63110-2515
(314) 977-5782
(314) 977-1628
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2002026771
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140893300
DOL
—
01
—
140894000
DOL
—
01
—
193990
MO BLUE
—
01
—
2002026771
CHAMPUS
—
01
—
205998214
MO CAID
—
01
—
205998222
MO CAID
—
01
—
2095276
AETNA
—
01
—
25010487
MO CARE
—
01
—
26632
GHP
—
01
—
4316563150PE
MERCY
—
01
—
537465
HL
—
01
—
65276
GHP
—
01
—
6668
GHP
—
01
—
686
B CHOICE
—
01
—
872
HEALTHCARE US
—
01
—
F58916
MERCY
—
Enumeration date
07/17/2006
Last updated
02/08/2021
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