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General NPI Number Information
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NPI Number | 1902834609
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Entity Type | Organization
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Legal Business Name | WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 201 NORTH A ST
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City | FARMINGTON
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State | MO
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Zip | 63640
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Country | US
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Telephone | 573-760-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 7425 FORSYTH BLVD CAMPUS BOX 8221
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City | SAINT LOUIS
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State | MO
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Zip | 63105-2171
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Country | US
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Telephone | 314-935-0770
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Fax | 314-935-0575
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Authorized Official
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Title or Position | DIRECTOR, CREDENTIALING OPERATIONS
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Name | CATHY EGHIGIAN
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Credential |
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Telephone | 314-935-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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