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General NPI Number Information
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NPI Number | 1922130848
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Entity Type | Organization
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Legal Business Name | MISSOURI INTERNISTS
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 621 S NEW BALLAS RD SUITE 142A
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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 | 314-251-5780
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Fax | 314-251-4466
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Provider Business Mailing Address
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Address Line | 621 S NEW BALLAS RD SUITE 142A
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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 | 314-251-5780
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Fax | 314-251-4466
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Authorized Official
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Title or Position | CMO VICE PRESIDENT OF MED AFFAIRS
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Name | PAUL F. HINTZE
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Credential | MD
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Telephone | 314-251-1955
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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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