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General NPI Number Information
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NPI Number | 1316053077
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Entity Type | Organization
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Legal Business Name | CLINIC OF INTERNAL MEDICINE, LLC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 121 SAINT LUKES CENTER DR STE 506
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3519
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Country | US
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Telephone | 314-576-8102
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Fax | 314-590-5930
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Provider Business Mailing Address
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Address Line | 232 S WOODS MILL RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3406
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Country | US
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Telephone | 636-685-7804
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Fax | 314-576-2473
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DARREN R. HASKELL
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Credential | M.D.
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Telephone | 314-205-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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