Ssm St. Charles Clinic Medical Group, Inc.

NPI #1285741629 in Troy, Missouri

Provider Information

NPI Number: 1285741629
Entity Type: Organization
Organization Name: Ssm St. Charles Clinic Medical Group, Inc.
Primary Specialty: Internal Medicine
Enumeration Date: Aug 23, 2006
Last Updated: Jan 15, 2016

Practice Location

Address: 172 PROFESSIONAL PARKWAY
City: Troy
State: Missouri
ZIP Code: 63379-1520
Phone: (636) 462-6106

Authorized Official

Name: MS. LAURA PULLUM
Title: BILLING MANAGER
Phone: (636) 669-2434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine - Cardiovascular Disease — Cardiovascular Disease	207RC0000X
Internal Medicine	207R00000X	Primary

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