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General NPI Number Information
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NPI Number | 1972401297
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Entity Type | Organization
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Legal Business Name | STL ELITE MEDICAL TEAM LLC
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Dates
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Enumeration Date | 10/27/2026
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Last Update Date | 10/27/2026
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Provider Practice Location Address
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Address Line | 3466 BRIDGELAND DR STE 250
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City | BRIDGETON
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State | MO
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Zip | 63044-2600
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Country | US
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Telephone | 314-887-2862
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Fax |
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Provider Business Mailing Address
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Address Line | 3466 BRIDGELAND DR STE 250
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City | BRIDGETON
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State | MO
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Zip | 63044-2600
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Country | US
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Telephone | 314-887-2862
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JENNIFER BLOOD
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Credential | JD
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Telephone | 314-761-6391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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