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1023045655

NPI Code Detail

MEDICARE: DR. PETER SCOTT EMERSON MD

MEDICARE: DR. PETER SCOTT EMERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	2013032975	MO
2	207R00000X	Internal Medicine Physician	2013032975	MO
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	2013032975	MO
4	207R00000X	Internal Medicine Physician	48963	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023045655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER SCOTT EMERSON MD

Provider Business Mailing Address
First Line	:	12101 WOODCREST EXECUTIVE DR
Second Line	:	SUITE 210
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-5047
Country	:	US
Telephone Number	:	314-317-0600
Fax Number	:	314-317-0606

Provider Business Practice Location Address
First Line	:	6420 CLAYTON RD
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1811
Country	:	US
Telephone Number	:	314-317-0600
Fax Number	:	314-317-0606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	11/11/2014

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Directions to “ DR. PETER SCOTT EMERSON MD” Practice Location

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