| Ssm St. Charles Clinic Medical Group, Inc. | |
|
722 N Highway 47 Suite B Warrenton MO 63383-1108 | |
| (636) 456-3413 | |
| (636) 669-2401 |
| Full Name | Ssm St. Charles Clinic Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 722 N Highway 47, Warrenton, Missouri |
| Authorized Official Name and Position | Laura Pullum (BILLING MANAGER) |
| Authorized Official Contact | 6366692434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm St. Charles Clinic Medical Group, Inc. 1551 Wall St Suite 310 Saint Charles MO 63303-3539 Ph: (636) 669-2268 | Ssm St. Charles Clinic Medical Group, Inc. 722 N Highway 47 Suite B Warrenton MO 63383-1108 Ph: (636) 456-3413 |
| NPI Number | 1578670949 |
|---|---|
| Provider Enumeration Date | 08/23/2006 |
| Last Update Date | 01/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578670949 | NPI | - | NPPES |
| 501133649 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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