Healthcare Provider Details

I. General information

NPI: 1043955503
Provider Name (Legal Business Name): SSM HEALTH CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S GRAND BLVD RM 463
SAINT LOUIS MO
63104-1004
US

IV. Provider business mailing address

PO BOX 954467
SAINT LOUIS MO
63195-4467
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-8475
  • Fax: 314-268-5478
Mailing address:
  • Phone: 314-617-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZI0100X
TaxonomyImmunopathology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: EILEEN M LAMM
Title or Position: VICE PRESIDENT - FINANCE
Credential:
Phone: 314-994-6219