NPI 1659415578

Physician Groups Lc

Organisation Colon & Rectal Surgery Physician Saint Louis, MO

Practice location

Address: 11155 Dunn Rd Suite 312e Building 1, Saint Louis, MO 63136-6150
Phone: (314) 741-0430
Mailing address: 670 Mason Ridge Center Dr Suite 300, Saint Louis, MO 63141-8573

Authorised official

Name: Raymond P Davidson
Title: President
Phone: (314) 286-2028

Registered specialties

Colon & Rectal Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208C00000X

Other Colon & Rectal Surgery providers in Missouri →

Registry record

NPI: 1659415578
Entity type: Organization
NPI issued: 16 Feb 2007
Record last updated: 2 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.