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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

NPI # 1891123477
LBN Legal business name SSM DEPAUL MEDICAL GROUP
Authorized official LAURA PULLUM - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/17/2013
Last updated 10/17/2013 - About 13 years ago
Identifiers
MO License # 2004019662
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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