Organization · Type 2 NPI

ST Louis University

Allergy & Immunology (Internal Medicine) Physician · St. Louis, MO

NPI number 1114149739 Active

Practice location

1225 South Grand, 2L, Door 3
St. Louis, MO 63104

Call (314) 977-9050 Map

Mailing address

3545 Lindell Blvd Fl 3
St. Louis, MO 63103-1020

Other practice locations

3660 Vista Ave, St. Louis, MO 63110-2540 · (314) 977-6100

Specialties and licenses

Taxonomy	Code	License
Allergy & Immunology (Internal Medicine) Physician Primary	207RA0201X	None listed

Allergy & Immunology (Internal Medicine) Physician: An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.

10 other providers at this address

NPI record

NPI: 1114149739
Entity type: Organization (Type 2)
Issued: May 3, 2007
Last updated: Sep 21, 2021
Status: Active

Other names

<unavail>
Slucare Dept of Internal Medicine-Allergy Immunology · doing business as
Slucare Dept of Internal Medicine-Allergy Immunology · doing business as

Authorized official

Alyce Lanxon
Executive Director
(314) 977-6828

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1114149739

ST Louis University's National Provider Identifier is 1114149739, issued on May 3, 2007. The primary taxonomy on file is Allergy & Immunology (Internal Medicine) Physician (207RA0201X), and the practice location is in St. Louis, MO. The record was last updated on Sep 21, 2021.