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General NPI Number Information
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NPI Number | 1861510877
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Entity Type | Organization
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Legal Business Name | COUNTY SPECIALIST
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16216 BAXTER RD SUITE 299
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City | CHESTERFIELD
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State | MO
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Zip | 63017-4770
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Country | US
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Telephone | 636-530-9999
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Fax | 636-530-0977
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Provider Business Mailing Address
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Address Line | 16216 BAXTER RD SUITE 299
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City | CHESTERFIELD
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State | MO
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Zip | 63017-4770
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Country | US
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Telephone | 636-530-9999
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Fax | 636-530-0977
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MYRTO FRANGOS
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Credential | M.D.
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Telephone | 636-530-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | MDRL34
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License Number State | MO
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