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General NPI Number Information
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NPI Number | 1194949727
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Entity Type | Organization
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Legal Business Name | SSM BERLAND EUREKA IMAGING SERVICES LLC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | #20 THE LEGENDS PARKWAY DRIVE SUITE 160
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City | EUREKA
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State | MO
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Zip | 63025
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Country | US
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Telephone | 636-938-1656
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Fax | 636-938-1674
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Provider Business Mailing Address
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Address Line | 774 N NEW BALLAS ROAD
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City | ST LOUIS
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State | MO
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Zip | 63141-6716
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Country | US
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Telephone | 314-567-1656
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Fax | 314-567-0622
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT D SEELIG
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Credential | MD
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Telephone | 314-567-1656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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