Stella Maris Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

103060 Issued in MO

Legal business name

STELLA MARIS INTERNAL MEDICINE LLC

Practice address

12855 N 40 Dr
Suite 350
Saint Louis, MO 63141-8635

Phone

(314) 205-1926

Fax

(314) 205-1076

NPI assigned

Jun 3, 2006

Last updated

Mar 17, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hani Charles Soudah, MD, PHD

Title

Doctor

Phone

(314) 205-1926

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1710925383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR",
            "address_2": "SUITE 350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418635",
            "telephone_number": "314-205-1926",
            "fax_number": "314-205-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR",
            "address_2": "SUITE 350",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418635",
            "telephone_number": "314-205-1926",
            "fax_number": "314-205-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLA MARIS INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "SOUDAH",
        "authorized_official_first_name": "HANI",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "314-205-1926",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "103060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Taylor Steinle, MD
• Alicia Steinmann, COTA
• Kelly Lynn Steinmetz, FNP
• Demi Renee Steinmeyer
• Theresa M Steins, MSW, CCDP-D
• Christine Hamill Stellner, R.D., L.D.
• Julia Stelmach
• Anne Stelter, LMSW
• Daniel J Stelzer, AA-C
• Stemen & Associates, LLC

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.