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General NPI Number Information
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NPI Number | 1982889861
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Entity Type | Organization
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Legal Business Name | DAVIS, WRIGHT, BERDY & SUFFIAN PC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 5551 WINGHAVEN BLVD STE 270
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City | O FALLON
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State | MO
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Zip | 63368-3629
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Country | US
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Telephone | 314-569-1881
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Fax | 314-569-3277
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Provider Business Mailing Address
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Address Line | 456 N NEW BALLAS RD SUITE 129
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6831
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Country | US
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Telephone | 314-569-1881
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Fax | 314-569-3277
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | BARBARA FAUPEL
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Credential |
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Telephone | 314-569-1881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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