is a Psychiatry in Creve Coeur, Missouri. practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for is 1245342161. The last update date is .
's current location address is 11710 Old Ballas Rd, Creve Coeur, Missouri. You can contact this provider via phone number 3145675000 and fax number 3145673110. The mailing address for is 11710 Old Ballas Rd, Creve Coeur, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 11710 Old Ballas Rd, Creve Coeur, Missouri |
| Phone Number | 3145675000 |
| Fax Number | 3145673110 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1245342161 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 11710 Old Ballas Rd |
|---|---|
| City | Creve Coeur |
| State | Missouri (MO) |
| Post Code | 631417076 |
| Phone Number | 3145675000 |
| Fax Number | 3145673110 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | MD100250 |
|
Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 105460 | MO | BLUE CROSS BLUE SHIELD | |
| 229025 | MO | HEALTHLINK | |
| 260029804 | MO | RR MEDICARE |
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