| Ssm Depaul Medical Group, Inc. | |
|
12255 De Paul Dr Suite 600 Bridgeton MO 63044-2510 | |
| (314) 291-1074 | |
| (314) 291-0802 |
| Full Name | Ssm Depaul Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 12255 De Paul Dr, Bridgeton, Missouri |
| Authorized Official Name and Position | Laura Lynn Pullum (DIRECTOR OF PATIENT ACCOUNTS) |
| Authorized Official Contact | 3142098121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Depaul Medical Group, Inc. 12255 De Paul Dr Suite 600 Bridgeton MO 63044-2510 Ph: (314) 291-1074 | Ssm Depaul Medical Group, Inc. 12255 De Paul Dr Suite 600 Bridgeton MO 63044-2510 Ph: (314) 291-1074 |
| NPI Number | 1174636575 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174636575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Ssm Depaul Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12255 De Paul Dr, Suite 200, Bridgeton, MO 63044 Phone: 314-344-7600 Fax: 314-344-7850 | |
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