MEDICARE: JAMES GINTHER M.D. P.C.

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	207R00000X	Internal Medicine Physician	R8955	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH2132	OTHER	MO	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1295848232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES GINTHER M.D. P.C.

Provider Business Mailing Address
First Line	:	6651 CHIPPEWA ST
Second Line	:	SUITE 322
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2538
Country	:	US
Telephone Number	:	314-457-9338
Fax Number	:	314-457-9341

Provider Business Practice Location Address
First Line	:	6651 CHIPPEWA ST
Second Line	:	SUITE 322
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2538
Country	:	US
Telephone Number	:	314-457-9338
Fax Number	:	314-457-9341

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	DR. JAMES W GINTHER JR.
Credential	:	M.D.
Telephone Number	:	314-457-9338

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	02/23/2015

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