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NPI Code Detail

MEDICARE: WESTEND MEDICAL CENTER PC

MEDICARE: WESTEND MEDICAL CENTER PC
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
1174400000XSpecialistR9B43MO

General Provider Information

NPI Number : 1316057565
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTEND MEDICAL CENTER PC
Provider Business Mailing Address
First Line : 6125 CLAYTON AVE
Second Line : STE 118
City : SAINT LOUIS
State : MO
Zip : 63139-3265
Country : US
Telephone Number : 314-367-4044
Fax Number : 314-367-1440
Provider Business Practice Location Address
First Line : 6125 CLAYTON AVE
Second Line : STE 118
City : SAINT LOUIS
State : MO
Zip : 63139-3265
Country : US
Telephone Number : 314-367-4044
Fax Number : 314-367-1440
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. VALERIE O WALKER
Credential : M.D.
Telephone Number : 314-367-4044
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/03/2007

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Directions to “WESTEND MEDICAL CENTER PC ” Practice Location

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