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NPI 1952810129

NPI 1952810129 : MERCY CLINIC MATERNAL FETAL MEDICINE LLC : SAINT LOUIS, MO

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General NPI Number Information
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    NPI Number           |    1952810129
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    Entity Type          |    Organization 
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    Legal Business Name  |    MERCY CLINIC MATERNAL FETAL MEDICINE LLC 
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Dates
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    Enumeration Date     |    09/20/2017
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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 STE 2007B 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63141-8265
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    Country              |    US
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    Telephone            |    314-991-1000
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    Fax                  |    314-991-5035
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Provider Business Mailing Address
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    Address Line         |    621 S NEW BALLAS RD STE 2007B 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63141-8265
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    Country              |    US
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    Telephone            |    314-991-1000
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    Fax                  |    314-991-5035
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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        |    207VM0101X
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    Taxonomy Name        |    Maternal & Fetal Medicine Physician
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    License Number       |    
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    License Number State |    
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