Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Student Health |
261QS1000X | |||
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine |
| NPI # | 1598886970 |
| LBN Legal business name | ST LOUIS UNIVERSITY |
| Authorized official | ALYCE LANXON - (EXECUTIVE DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/03/2007 |
| Last updated | 09/21/2021 - About 5 years ago |
| Identifiers | n/a |
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ST LOUIS UNIVERSITY
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