| Midwest Emergency Associates De Paul Llc | |
|
12303 Depaul Dr Bridgeton MO 63044 | |
| (314) 344-6000 | |
| (630) 734-1560 |
| Full Name | Midwest Emergency Associates De Paul Llc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 12303 Depaul Dr, Bridgeton, Missouri |
| Authorized Official Name and Position | Daniel Sullivan (PRESIDENT) |
| Authorized Official Contact | 6307340200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Emergency Associates De Paul Llc Po Box 5990 Dept 20 6006 Carol Stream IL 60197-5990 Ph: (630) 734-0200 | Midwest Emergency Associates De Paul Llc 12303 Depaul Dr Bridgeton MO 63044 Ph: (314) 344-6000 |
| NPI Number | 1265479448 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 02/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265479448 | NPI | - | NPPES |
| 506085505 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207P00000X | Emergency 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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