| SSM Health Medical Group on Demand | |
|
30 Ronnies Plz Sappington MO 63126-3552 | |
| (314) 989-6807 | |
| (314) 989-6608 |
| Full Name | SSM Health Medical Group on Demand |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 30 Ronnies Plz, Sappington, Missouri |
| Authorized Official Name and Position | Crystal L Pena (PROVIDER COORDINATOR) |
| Authorized Official Contact | 4052727452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| SSM Health Medical Group on Demand 30 Ronnies Plz Sappington MO 63126-3552 Ph: (314) 989-6807 | SSM Health Medical Group on Demand 30 Ronnies Plz Sappington MO 63126-3552 Ph: (314) 989-6807 |
| NPI Number | 1851971550 |
|---|---|
| Provider Enumeration Date | 04/08/2021 |
| Last Update Date | 04/08/2021 |
| Certification Date | 04/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851971550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
Children's Permanency Partnership Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10024 Office Center Ave, Sappington, MO 63128 Phone: 314-733-5759 |