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1 Barnes Jewish Hospital Plz Suite 16422 Saint Louis MO 63110-1003 | |
| (314) 367-9595 | |
| (314) 367-3647 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1 Barnes Jewish Hospital Plz, Saint Louis, Missouri |
| Authorized Official Name and Position | Raymond P Davidson (PRESIDENT) |
| Authorized Official Contact | 3142862028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 | 1 Barnes Jewish Hospital Plz Suite 16422 Saint Louis MO 63110-1003 Ph: (314) 367-9595 |
| NPI Number | 1992872345 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992872345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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