Healthcare Provider Details
I. General information
NPI: 1306828074
Provider Name (Legal Business Name): ALVIN K SCHERGEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/17/2005
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6400 CLAYTON RD SUITE 302
SAINT LOUIS MO
63117-1850
US
IV. Provider business mailing address
10777 SUNSET OFFICE DR SUITE 310
SAINT LOUIS MO
63127-1019
US
V. Phone/Fax
- Phone: 314-645-3370
- Fax: 314-645-0576
- Phone: 314-822-5900
- Fax: 314-822-5919
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | R8B76 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: