National Provider Identifier Database

BRIDGETON PAIN GROUP
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

BRIDGETON PAIN GROUP
11520 SAINT CHARLES ROCK RD STE 201
BRIDGETON, MO63044
Phone: 314-526-6093
Fax:
Website:
Specialty Taxonomy Code
* General Practice 208D00000X

* Indicates primary specialty

NPI Profile & details for BRIDGETON PAIN GROUP

NPI Number 1114626462
Legal business name
LBN
BRIDGETON PAIN GROUP
Authorized official MITCHELL LIBERMAN - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 02/27/2023
Last updated 10/30/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers n/a

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.

Reviews for BRIDGETON PAIN GROUP

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