Healthcare Provider Details

I. General information

NPI: 1265843148
Provider Name (Legal Business Name): MERAMEC EMERGENCY PHYSICIANS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHWAY 21 N
ELLINGTON MO
63638-9409
US

IV. Provider business mailing address

75 REMIT DR SUITE 1131
CHICAGO IL
60675-1131
US

V. Phone/Fax

Practice location:
  • Phone: 573-663-2511
  • Fax:
Mailing address:
  • Phone: 866-916-5259
  • Fax: 231-922-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DERIK K KING
Title or Position: MANAGING PARTNER
Credential:
Phone: 866-916-5259