MEDICARE: CARDIO-PULMONARY AFFILIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1275049306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIO-PULMONARY AFFILIATES LLC

Provider Business Mailing Address
First Line	:	232 S WOODS MILL RD
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3406
Country	:	US
Telephone Number	:	636-685-7804
Fax Number	:	314-576-2344

Provider Business Practice Location Address
First Line	:	222 S WOODS MILL RD STE 310N
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-3627
Country	:	US
Telephone Number	:	314-682-3630
Fax Number	:	314-682-3647

Authorized Official
Title or Position	:	VP PHYSICIAN NETWORK
Name	:	JAMES SNIDER
Credential	:
Telephone Number	:	636-685-7804

Provider Enumeration Date	:	12/27/2017
Last Update Date	:	03/05/2026

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