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NPI Code Detail

MEDICARE: WASHINGTON UNIVERSITY

MEDICARE: WASHINGTON UNIVERSITY
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
1261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115-01999OTHERMOUHC GROUP NUMBER
2673341OTHERMOAETNA HMO GROUP NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
492215225OTHERILIL BLUE SHIELD
5610916400OTHERMODEPT OF LABOR NUMBER

General Provider Information

NPI Number : 1285674754
Entity Type Code : Organization
Provider Name (Legal Business Name) : WASHINGTON UNIVERSITY
Provider Business Mailing Address
First Line : 7425 FORSYTH BLVD
Second Line : CAMPUS BOX 8221
City : SAINT LOUIS
State : MO
Zip : 63105-2171
Country : US
Telephone Number : 314-935-0770
Fax Number : 314-935-0575
Provider Business Practice Location Address
First Line : 660 S EUCLID AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-1010
Country : US
Telephone Number : 314-286-1045
Fax Number : 314-286-1051
Authorized Official
Title or Position : DIRECTOR, CREDENTIALING OPERATIONS
Name : MS. CATHY L EGHIGIAN
Credential :
Telephone Number : 314-273-0770
Provider Enumeration Date : 06/06/2006
Last Update Date : 11/03/2020

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1316987886 — WASHINGTON UNIVERSITY
Practice Location Address:
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Directions to “WASHINGTON UNIVERSITY ” Practice Location

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