Individual
SUSAN R ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
637 DUNN RD STE 170, HAZELWOOD, MO 63042-1759
(314) 838-5702
(314) 839-5596
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 838-5702
(314) 839-5596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
100517
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010005
ESSENCE
MO
01
—
0400395
UHC
MO
01
—
127450
GHP
MO
01
—
172501
HEALTHLINK
MO
01
—
28144
BCBS
MO
01
—
4226213
AETNA
MO
01
—
F37554
MERCY
MO
Enumeration date
11/02/2005
Last updated
02/08/2019
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