Ssm Health Care St Louis in Fenton - Vascular Surgery
Ssm Health Care St Louis - NPI 1275586174
Ssm Health Care St Louis is a Vascular Surgery in Fenton, Missouri. Ssm Health Care St Louis practices all healthcare services and medical treatments related to Vascular Surgery. The NPI Number for Ssm Health Care St Louis is 1275586174. The last update date is 2019-03-12.
Ssm Health Care St Louis's current location address is 1015 Bowles Avenue, Fenton, Missouri. You can contact this provider via phone number 6364962502. The mailing address for Ssm Health Care St Louis is 1015 Bowles Avenue, Fenton, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Ssm Health Care St Louis |
|---|---|
| Address | 1015 Bowles Avenue, Fenton, Missouri |
| Phone Number | 6364962502 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EVP/COO |
|---|---|
| Authorized Official Name | Dudley R. Sharon |
| Telephone Number | 3147688032 |
NPI Number Detail
| NPI Number | 1275586174 |
|---|---|
| Provider Enumeration Date | 2006-05-19 |
| Last Updated Date | 2019-03-12 |
Provider Mailing Address Detail
| Address | 1015 Bowles Avenue |
|---|---|
| City | Fenton |
| State | Missouri (MO) |
| Post Code | 63026 |
| Phone Number | 6364962502 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Vascular Surgery |
|---|---|
| Taxonomy | 2086S0129X |
|
Definition: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 545011009 | MO | -- |
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What is the Ssm Health Care St Louis's unique identification number?
The Ssm Health Care St Louis has been assigned the NPI (National Provider Identifier) Number 1275586174 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Ssm Health Care St Louis?
The Ssm Health Care St Louis is situated at 1015 Bowles Avenue, in the city of Fenton, state of MO, with the zip code 63026.
What is Ssm Health Care St Louis's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Ssm Health Care St Louis is Vascular Surgery, and the corresponding taxonomy classification code for this specialized field is 2086S0129X.
On what date did the Ssm Health Care St Louis receive the assignment of its 1275586174 from the Centers for Medicare & Medicaid Services?
The Ssm Health Care St Louis was issued its 1275586174 by the Centers for Medicare & Medicaid Services on 2006-05-19.
As of what date were the Ssm Health Care St Louis's details last updated?
The information pertaining to the Ssm Health Care St Louis, including its address, specialty, and other details, was most recently updated on 2019-03-12.