MEDICARE: REPRODUCTIVE MEDICAL ASSOCIATES OF ST LOUIS

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	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1265929459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REPRODUCTIVE MEDICAL ASSOCIATES OF ST LOUIS

Provider Business Mailing Address
First Line	:	641 N NEW BALLAS RD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-6713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 N NEW BALLAS RD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-6713
Country	:	US
Telephone Number	:	314-312-2878
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MAUREEN SCHULTE
Credential	:	MD
Telephone Number	:	314-312-2878

Provider Enumeration Date	:	04/13/2018
Last Update Date	:	04/13/2018

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