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General NPI Number Information
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NPI Number | 1841209871
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Entity Type | Individual
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Provider Name | AMY POOLE-YAEGER M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 232 S WOODS MILL RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3417
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Country | US
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Telephone | 314-542-4897
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Fax |
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Provider Business Mailing Address
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Address Line | 224 S WOODS MILL RD SUITE 210 SOUTH
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3451
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Country | US
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Telephone | 314-542-4897
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Fax | 314-205-6003
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 106363
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License Number State | MO
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