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General NPI Number Information
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NPI Number | 1902197767
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S FAMILY MEDICINE - MARYLAND HEIGHTS LLC
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 915 FEE FEE RD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3801
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Country | US
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Telephone | 314-770-1777
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Fax | 314-590-5952
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Provider Business Mailing Address
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Address Line | 915 FEE FEE RD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3801
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Country | US
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Telephone | 314-770-1777
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Fax | 314-770-1776
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MR. DARREN HASKELL
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Credential | MD.
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Telephone | 314-205-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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