Healthcare Provider Details

I. General information

NPI: 1871594564
Provider Name (Legal Business Name): ARTURO J PAMAONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11903 SAINT CHARLES ROCK RD BACK PAIN INSTITUTE OF ST. LOUIS LLC
BRIDGETON MO
63044-2623
US

IV. Provider business mailing address

11903 SAINT CHARLES ROCK RD BACK PAIN INSTITUTE OF ST. LOUIS LLC
BRIDGETON MO
63044-2623
US

V. Phone/Fax

Practice location:
  • Phone: 314-770-0900
  • Fax: 314-770-1623
Mailing address:
  • Phone: 314-770-0900
  • Fax: 314-739-8569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number8102
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number8102
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: