Healthcare Provider Details

I. General information

NPI: 1265929459
Provider Name (Legal Business Name): REPRODUCTIVE MEDICAL ASSOCIATES OF ST LOUIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 N NEW BALLAS RD
CREVE COEUR MO
63141-6713
US

IV. Provider business mailing address

641 N NEW BALLAS RD
CREVE COEUR MO
63141-6713
US

V. Phone/Fax

Practice location:
  • Phone: 314-312-2878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN SCHULTE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 314-312-2878