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Contact Information

SSM DEPAUL MEDICAL GROUP, INC.
2024 DORSETT VLG
MARYLAND HEIGHTS, MO63043-2208
 Phone: 314-590-0550
 Fax: 314-590-0560
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SSM DEPAUL MEDICAL GROUP INC · (Female)

NPI Number 1760456743
Status Active
Credentials
Entity Individual
Enumeration date 02/15/2006
Last updated 01/15/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO Medicaid 502915705
  • MO Other CJ7983 RAILROAD MEDICARE
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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