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General NPI Number Information
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NPI Number | 1750571840
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Entity Type | Individual
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Provider Name | EMAN GIBRAL SPAULDING M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 3635 VISTA AVE
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City | ST. LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-577-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 9776 TWIN VISTA DR
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City | SAINT LOUIS
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State | MO
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Zip | 63126-1938
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Country | US
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Telephone | 615-491-3688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2011035900
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License Number State | MO
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