Fenton Emergency Group LLC

NPI #1770832792 in Fenton, Missouri

Provider Information

NPI Number: 1770832792
Entity Type: Organization
Organization Name: Fenton Emergency Group LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Sep 5, 2012
Last Updated: Jan 2, 2020

Practice Location

Address: 1015 BOWLES AVE
City: Fenton
State: Missouri
ZIP Code: 63026-2394
Phone: (636) 496-2100

Authorized Official

Name: LISHA C FALK
Title: VP OF CONTRACTING
Phone: (800) 893-9698

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Emergency Medicine	207P00000X	Primary

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