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General NPI Number Information
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NPI Number | 1356514012
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Entity Type | Organization
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Legal Business Name | WASHINGTON UNIVERSITY IN ST. LOUIS
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 4940 PARKVIEW PL CAMPUS BOX 8230
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1025
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Country | US
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Telephone | 314-362-7650
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Fax |
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Provider Business Mailing Address
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Address Line | 4940 PARKVIEW PL CAMPUS BOX 8230
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1025
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Country | US
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Telephone |
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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. DAVID JOSEPH RIDDLE
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Credential | M.D.
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Telephone | 314-362-7650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2001013439
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License Number State | MO
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