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General NPI Number Information
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NPI Number | 1902141641
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Entity Type | Organization
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Legal Business Name | MERCY CLINIC INFECTIOUS DISEASE LLC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 621 S NEW BALLAS RD SUITE 140A
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8232
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Country | US
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Telephone | 314-251-8897
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Fax | 314-251-8898
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Provider Business Mailing Address
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Address Line | 621 S NEW BALLAS RD SUITE 140A
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8232
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Country | US
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Telephone | 314-251-8897
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Fax | 314-251-8898
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR - FINANCE
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Name | KERRY DUNGER
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Credential |
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Telephone | 314-364-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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