Healthcare Provider Details

I. General information

NPI: 1083171474
Provider Name (Legal Business Name): SAFE TRANSITIONS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 SOVEREIGN CT STE A
BALLWIN MO
63011-4447
US

IV. Provider business mailing address

452 SOVEREIGN CT STE A
BALLWIN MO
63011-4447
US

V. Phone/Fax

Practice location:
  • Phone: 636-222-8699
  • Fax: 636-238-5434
Mailing address:
  • Phone: 636-222-8699
  • Fax: 636-238-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUNIER EL-BECK
Title or Position: PRESIDENT/AUTHORIZED OFFICIAL
Credential: MD
Phone: 636-222-8699