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Contact Information

BRIDGETON EMERGENCY GROUP LLC
12303 DE PAUL DR
BRIDGETON, MO63044-2512
 Phone: 800-893-9698
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for BRIDGETON EMERGENCY GROUP LLC · (Female)

NPI # 1053660076
Status Active
Credentials
Entity Individual
Enumeration date 09/05/2012
Last updated 01/14/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO Medicaid 1053660076
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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