Family Medicine Of South City, LLC
Clinic/Center in Saint Louis, MO. Organization (NPI-2).
NPI number1609976752
StatusActive
Last updated in NPPESNov 4, 2010
Details
- NPI
- 1609976752
- Entity type
- Organization (NPI-2)
- Legal business name
- Family Medicine Of South City, LLC
- Organization subpart
- No
- Enumeration date
- Sep 25, 2006
- Last updated
- Nov 4, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
3915 Watson RdSte 203
Saint Louis, MO 63109-1251
Phone 314-644-4410 · Fax 314-646-0054
Mailing address
3915 Watson RdSte 203
Saint Louis, MO 63109-1251
Phone 314-644-4410 · Fax 314-646-0054
Authorized official
Edina Karahodzic
Owner
3146444410
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