Healthcare Provider Details

I. General information

NPI: 1871908798
Provider Name (Legal Business Name): LAUREN SUCHER-O'GRADY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S EUCLID AVE MAILSTOP 90-75-587
SAINT LOUIS MO
63110-1010
US

IV. Provider business mailing address

660 S EUCLID AVE MAILSTOP 90-75-587
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-5000
  • Fax:
Mailing address:
  • Phone: 314-362-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2014016512
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: