SSM Medical Group
Organization Active NPI Internal Medicine Physician · Fenton, MO
NPI 1023218898 · NPPES record last updated Jul 8, 2009
Key facts
- NPI
- 1023218898
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- SSM MEDICAL GROUP
- Practice address
- 1011 Bowles Ave
Suite 300
Fenton, MO 63026-2387 - Phone
- (636) 496-5000
- Fax
- (636) 496-5045
- NPI assigned
- Jul 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. James E Bieser
- Title
- Executive Director
- Phone
- (314) 822-5900
National Provider Directory
Locations
1011 Bowles Ave
Ste 300
Fenton, MO 63026
Phone (636) 496-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
1011 Bowles Ave
Suite 300
Fenton, MO 63026-2387
Mailing address
1011 Bowles Ave
Suite 300
Fenton, MO 63026-2387
Phone (636) 496-5000
Other names
- Suburban West Internal Medicine
Other providers in Fenton, MO
- Specialt MRI, LLC
- Angela Rae Sqrow
- Hari Thanigaraj Srihari
- SSM Health Care St Louis
- SSM Health Care St. Louis
- SSM Medical Group
- SSM Medical Group
- SSM Medical Group Inc.
- SSM Medical Group, Inc.
- SSM St Clare Surgical Center LLC
All providers in Fenton, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.