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General NPI Number Information
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NPI Number | 1487924288
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE AT WINGHAVEN, LLC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 5551 WINGHAVEN BLVD STE 290
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City | O FALLON
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State | MO
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Zip | 63368-3629
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Country | US
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Telephone | 636-695-2575
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Fax | 314-590-5938
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Provider Business Mailing Address
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Address Line | 121 SAINT LUKES CENTER DR STE 200
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3518
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Country | US
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Telephone | 636-685-7804
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Fax | 314-576-2433
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DARREN 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 | 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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