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Contact Information

SSM DEPAUL MEDICAL GROUP
1551 WALL ST
SUITE 400
SAINT CHARLES, MO63303-3539
 Phone: 636-669-2420
 Fax: 636-669-2401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Adult Medicine

207QA0505X 08 Physician/Family Practice
Indicates primary specialty

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

NPI # 1891123477
Status Active
Credentials
Entity Individual
Enumeration date 10/17/2013
Last updated 10/17/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # 2004019662
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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