Healthcare Provider Details
I. General information
NPI: 1831599059
Provider Name (Legal Business Name): SOUTH COUNTY WOMEN'S HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2014
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12345 W BEND DR 105
SAINT LOUIS MO
63128-2182
US
IV. Provider business mailing address
PO BOX 1645
FENTON MO
63026-1645
US
V. Phone/Fax
- Phone: 314-270-8051
- Fax: 314-270-9561
- Phone: 314-432-2580
- Fax: 314-432-0223
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANITA
SCHNAPP
Title or Position: OWNER
Credential: M.D.
Phone: 314-270-8051