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NPI Code Detail

MEDICARE: DR. ERIC SCOTT BAGGSTROM MD

MEDICARE: DR. ERIC SCOTT BAGGSTROM 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
1208M00000XHospitalist Physician2004036761MO
2207R00000XInternal Medicine Physician2004036761MO

Other Identifiers

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

General Provider Information

NPI Number : 1487677308
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC SCOTT BAGGSTROM MD
Provider Business Mailing Address
First Line : 1068 S WOODS MILL RD STE 220
Second Line :
City : TOWN AND COUNTRY
State : MO
Zip : 63017-8333
Country : US
Telephone Number : 314-394-1379
Fax Number : 314-394-1377
Provider Business Practice Location Address
First Line : 1068 S WOODS MILL RD STE 220
Second Line :
City : TOWN AND COUNTRY
State : MO
Zip : 63017-8333
Country : US
Telephone Number : 314-394-1379
Fax Number : 314-394-1377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 09/24/2019

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