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General NPI Number Information
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NPI Number | 1164446779
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Entity Type | Organization
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Legal Business Name | PEDIATRIX MEDICAL GROUP OF MISSOURI, P.C.
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 615 S NEW BALLAS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8221
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Country | US
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Telephone | 877-737-4546
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 CONCORD TER
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City | SUNRISE
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State | FL
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Zip | 33323-2843
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Country | US
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Telephone | 800-243-3839
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Fax | 844-686-2961
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | MICHAEL ASHFORD
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Credential |
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Telephone | 954-384-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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