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General NPI Number Information
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NPI Number | 1083734370
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Entity Type | Organization
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Legal Business Name | FLORSSANT COUNTY OB-GYN
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1224 GRAHAM RD STE 1113
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City | FLORISSANT
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State | MO
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Zip | 63031-8028
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Country | US
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Telephone | 314-839-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 GRAHAM RD STE 1113
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City | FLORISSANT
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State | MO
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Zip | 63031-8028
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Country | US
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Telephone | 314-839-4500
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHINDA ROJANASATHIT
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Credential | M.D.
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Telephone | 314-839-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35367
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License Number State | MO
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