Ssm Depaul Medical Group

NPI #1891123477 in Saint Charles, Missouri

Provider Information

NPI Number: 1891123477
Entity Type: Organization
Organization Name: Ssm Depaul Medical Group
Primary Specialty: Podiatrist
Enumeration Date: Oct 17, 2013
Last Updated: Oct 17, 2013

Practice Location

Address: 1551 WALL ST
Address 2: SUITE 400
City: Saint Charles
State: Missouri
ZIP Code: 63303-3539
Phone: (636) 669-2420

Authorized Official

Name: LAURA PULLUM
Title: DIRECTOR
Phone: (636) 669-2434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Adult Medicine — Adult Medicine	207QA0505X
Podiatrist	213E00000X	Primary

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