MEDICARE: DR. DUSTIN GARTH JAMES 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	207RG0100X	Gastroenterology Physician	2007006292	MO
2	207RG0100X	Gastroenterology Physician	P8793	TX

General Provider Information

NPI Number	:	1063538676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUSTIN GARTH JAMES MD

Provider Business Mailing Address
First Line	:	11718 LINDEMERE DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-4224
Country	:	US
Telephone Number	:	314-909-6957
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CHESTERFIELD BUSINESS PKWY STE 110
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63005-1271
Country	:	US
Telephone Number	:	636-532-0990
Fax Number	:	636-532-0993

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/06/2014

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