| Executive Neuropsychiatric Systems Incorporated | |
|
225 S Meramec Ave Suite 1221t Clayton MO 63105-3511 | |
| (314) 367-3050 | |
| (314) 367-3712 |
| Full Name | Executive Neuropsychiatric Systems Incorporated |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 225 S Meramec Ave, Clayton, Missouri |
| Authorized Official Name and Position | Susan Annette Minchin (PRESIDENT) |
| Authorized Official Contact | 3143673050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Neuropsychiatric Systems Incorporated 225 S Meramec Ave Suite 1221t Clayton MO 63105-3511 Ph: (314) 367-3050 | Executive Neuropsychiatric Systems Incorporated 225 S Meramec Ave Suite 1221t Clayton MO 63105-3511 Ph: (314) 367-3050 |
| NPI Number | 1790920023 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 07/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790920023 | NPI | - | NPPES |
| 000095333 | Other | MO | MEDICARE IDENTIFICATION NUMBER |
| 10853441 | Other | MO | CAQH IDENTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD102146 (Missouri) | Primary |
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