Evolution MD, LLC
Family Medicine in Saint Peters, MO. Organization (NPI-2).
NPI number1699425314
StatusActive
Last updated in NPPESAug 5, 2026
Details
- NPI
- 1699425314
- Entity type
- Organization (NPI-2)
- Legal business name
- Evolution MD, LLC
- Organization subpart
- No
- Enumeration date
- Mar 25, 2022
- Certification date
- Aug 5, 2026
- Last updated
- Aug 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
4127 Mexico RdSaint Peters, MO 63376-6410
Phone 636-534-0200 · Fax 636-534-0211
Mailing address
Po Box 37002Saint Louis, MO 63141-1502
Authorized official
Jose Marino Parra
Owner
6365340200
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