Organization · Type 2 NPI

ST Louis University

Pediatric Surgery Physician · St. Louis, MO

NPI number 1114990454 Active

Practice location

1465 S Grand Blvd
St. Louis, MO 63104-1003

Call (314) 977-6828 Map

Mailing address

1831 Chestnut St Ste 650
St. Louis, MO 63103-2236

Specialties and licenses

TaxonomyCodeLicense
Pediatric Surgery Physician Primary 2086S0120XNone listed

Pediatric Surgery Physician: A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

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About NPI 1114990454

ST Louis University's National Provider Identifier is 1114990454, issued on Feb 8, 2006. The primary taxonomy on file is Pediatric Surgery Physician (2086S0120X), and the practice location is in St. Louis, MO. The record was last updated on Jun 21, 2019.