INTERNAL MEDICINE AT WINGHAVEN LLC NPI 1033350541

NPI Information

NPI: 1033350541
Provider Name: INTERNAL MEDICINE AT WINGHAVEN LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 26D0952700

Address:
5551 WINGHAVEN BLVD STE 290
O FALLON, MO
ZIP 63368
Phone: (636) 695-2575
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INTERNAL MEDICINE AT WINGHAVEN LLC is a primary care clinic center in O Fallon, MO. INTERNAL MEDICINE AT WINGHAVEN LLC NPI is 1033350541. The provider is registered as an organization entity type.

The provider's business location address is:

5551 WINGHAVEN BLVD STE 290
O FALLON, MO
ZIP 63368-629
Phone: (636) 695-2575
Fax: (314) 590-5938

The provider's authorized official is Rick Sonne .
The authorized official title is Director and has the following contact phone number (314) 576-2490.

The CLIA number assigned to this NPI record is 26D0952700 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2009 and was last updated on 12/5/2017.

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
1	261QP2300X	Clinic/Center	Primary Care	R8F27	MISSOURI	Yes

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

NPI Synchronization or Removal

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