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General NPI Number Information
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NPI Number | 1710265574
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Entity Type | Organization
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Legal Business Name | ST ANTHONYS PHYSICIAN ORGANIZATION HOSPITALIST SERVICES, L.C.
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 10010 KENNERLY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2106
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Country | US
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Telephone | 314-525-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 10010 KENNERLY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2106
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Country | US
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Telephone | 314-525-1500
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Fax |
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Authorized Official
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Title or Position | CFO EAST COMMUNITIES & SFO
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Name | CHERYL MATEJKA
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Credential |
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Telephone | 314-251-1958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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