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General NPI Number Information
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NPI Number | 1851896146
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Entity Type | Organization
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Legal Business Name | SSM MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1101 HIGHWAY K STE A
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City | O FALLON
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State | MO
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Zip | 63366-8431
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Country | US
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Telephone | 844-766-7200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 955534
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City | SAINT LOUIS
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State | MO
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Zip | 63195-5534
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGIONAL VP FINANCE
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Name | EILEEN LAMM
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Credential |
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Telephone | 149-946-2193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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