Healthcare Provider Details

I. General information

NPI: 1548125008
Provider Name (Legal Business Name): SAINT LOUIS SURGICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 CLAYTON RD STE 303
SAINT LOUIS MO
63117-1850
US

IV. Provider business mailing address

7452 AMHERST AVE
SAINT LOUIS MO
63130-2933
US

V. Phone/Fax

Practice location:
  • Phone: 314-488-0300
  • Fax:
Mailing address:
  • Phone: 314-488-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA MOHRMAN
Title or Position: OWNER
Credential: MD
Phone: 314-488-0300