Ann Sudekum, M.D.
Individual provider Active NPI Specialist · Frontenac, MO
NPI 1306239959 · NPPES record last updated Mar 6, 2015
Key facts
- NPI
- 1306239959
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- R5101 (MO)
- Practice address
- 841 Chapel Oaks Rd
Frontenac, MO 63131-2805 - Phone
- (314) 650-9902
- NPI assigned
- Mar 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5101 | MO | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | R5101 | MO | Yes |
Addresses
Primary practice location
841 Chapel Oaks Rd
Frontenac, MO 63131-2805
Mailing address
841 Chapel Oaks Rd
Frontenac, MO 63131-2805
Phone (314) 650-9902
Other providers in Frontenac, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2015. 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.