Healthcare Provider Details

I. General information

NPI: 1275541187
Provider Name (Legal Business Name): RHEUMATOLOGY & INTERNAL MEDICINE ASSOCIATES OF WEST COUNTY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 N BALLAS ROAD PROFESSIONAL OFFICE BUILDING D SUITE 500
ST LOUIS MO
63131
US

IV. Provider business mailing address

3023 N BALLAS ROAD PROFESSIONAL OFFICE BUILDING D SUITE 500
ST LOUIS MO
63131
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-4541
  • Fax: 314-569-3647
Mailing address:
  • Phone: 314-567-4541
  • Fax: 314-569-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J SCHNEIDER
Title or Position: PRESIDENT
Credential: MD
Phone: 314-567-4541