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1701 S Florissant Rd, Saint Louis, MO 63121-1131 | |
(314) 522-0042 | |
(314) 521-8629 |
Full Name | |
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Type | Facility |
Speciality | General Practice |
Location | 1701 S Florissant Rd, Saint Louis, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1730576224 | NPI | - | NPPES |
Provider Name | Jawed H Siddiqui |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1699705293 PECOS PAC ID: 5799762415 Enrollment ID: I20040701000288 |
Provider Name | Donna M Baudendistel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417904624 PECOS PAC ID: 8325007974 Enrollment ID: I20041008000148 |
Provider Name | David A Sciortino |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1497882088 PECOS PAC ID: 1850550716 Enrollment ID: I20120313000119 |
Mailing Address | Practice Location Address |
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1701 S Florissant Rd, Saint Louis, MO 63121-1131 Ph: (314) 522-0042 | 1701 S Florissant Rd, Saint Louis, MO 63121-1131 Ph: (314) 522-0042 |