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General NPI Number Information
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NPI Number | 1992802433
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Entity Type | Organization
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Legal Business Name | RC PHYSICIAN SERVICES, LLC
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 9200 WATSON RD.
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City | ST LOUIS
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State | MO
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Zip | 63126
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Country | US
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Telephone | 314-962-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 WATSON RD.
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City | ST LOUIS
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State | MO
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Zip | 63126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN WALTERSCHEID
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Credential | M.D.
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Telephone | 314-962-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24807
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License Number State | MO
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