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SSM DEPAUL MEDICAL GROUP INC. NPI 1003929407


NPI Information

NPI: 1003929407
Provider Name: SSM DEPAUL MEDICAL GROUP, INC.

Doing Business As: FAMILY MEDICINE AT DEPAUL

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
12255 DE PAUL DR
SUITE 200
BRIDGETON, MO
ZIP 63044
Phone: (314) 344-7600
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SSM DEPAUL MEDICAL GROUP, INC. is a family medicine in Bridgeton, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SSM DEPAUL MEDICAL GROUP, INC. NPI is 1003929407. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Medicine At Depaul.

The provider's business location address is:

12255 DE PAUL DR
SUITE 200
BRIDGETON, MO
ZIP 63044-510
Phone: (314) 344-7600
Fax: (314) 344-7850

The provider's authorized official is Laura Lynn Pullum .
The authorized official title is Director Of Patient Accounts and has the following contact phone number (314) 209-8121.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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