Healthcare Provider Details

I. General information

NPI: 1356185821
Provider Name (Legal Business Name): MARIA CHALFOUN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

MERCY CRITICAL CARE MEDICINE 625 SOUTH NEW BALLAS ROAD, SUITE 7020
ST. LOUIS MO
52141
US

V. Phone/Fax

Practice location:
  • Phone: 314-617-2000
  • Fax:
Mailing address:
  • Phone: 314-251-6486
  • Fax: 314-251-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2024008008
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: