Organization · Type 2 NPI

ST Louis University

Pediatric Adolescent Medicine Physician · St. Louis, MO

NPI number 1932328796 Active

Practice location

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

Call (314) 268-6406 Map

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Pediatric Adolescent Medicine Physician Primary	2080A0000X	None listed

Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

572 other providers at this address

Other pediatric adolescent medicine physician providers in St. Louis

Affton Medical ClinicPediatric Adolescent Medicine Physician St. Louis, MO NPI 1114048154

See all in St. Louis →

NPI record

NPI: 1932328796
Entity type: Organization (Type 2)
Issued: Apr 24, 2007
Last updated: Sep 21, 2021
Status: Active

Other names

<unavail>
Slucare Dept of Pediatric Adolescent Medicine · doing business as
Slucare Dept of Pediatric Adolescent Medicine · 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 1932328796

ST Louis University's National Provider Identifier is 1932328796, issued on Apr 24, 2007. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in St. Louis, MO. The record was last updated on Sep 21, 2021.