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General NPI Number Information
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NPI Number | 1376731828
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Entity Type | Organization
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Legal Business Name | CONSULTANTS IN OB GYN INC
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 621 S NEW BALLAS RD SUITE399
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8232
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Country | US
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Telephone | 314-251-6644
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Fax | 314-251-6891
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Provider Business Mailing Address
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Address Line | 621 S NEW BALLAS RD SUITE399
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8232
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Country | US
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Telephone | 314-251-6644
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Fax | 314-251-6891
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. ROBERT L BECKER
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Credential | M.D.
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Telephone | 314-251-6644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 32180
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License Number State | MO
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