SOUTHSIDE MEDICAL GROUP PC
NPI 1912101486
Specialist in Saint Louis, MO
- Organization
- Specialist
About SOUTHSIDE MEDICAL GROUP PC
This page provides the complete NPI Profile along with additional information for Southside Medical Group Pc, a provider established in Saint Louis, Missouri operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1912101486 assigned on June 2007. The practitioner's primary taxonomy code is 174400000X with license number R77046 (MO). The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Subodh K Mehra M.d. (Doctor)
- NPI
- 1912101486 Verify this NPI
- Provider Name
- SOUTHSIDE MEDICAL GROUP PC
- Entity Type
- Organization
- Location Address
- 9700 MACKENZIE RD STE 105 SAINT LOUIS, MO 63123
- Location Phone
- (314) 638-9100
- Mailing Address
- 9700 MACKENZIE RD STE 105 SAINT LOUIS, MO 63123
- Mailing Phone
- (314) 638-9100
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-11-2007
- Last Update Date
- 08-28-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- R77046
- License State
- MO
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Reviews for SOUTHSIDE MEDICAL GROUP PC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912101486, enumerated as an "organization" on June 11, 2007.
The provider is located at 9700 MACKENZIE RD STE 105 SAINT LOUIS, MO 63123 and the phone number is (314) 638-9100.
Specialist with taxonomy code 174400000X.
