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SOUTHSIDE MEDICAL GROUP PC
NPI 1912101486
Specialist in Saint Louis, MO

Active since June 11, 2007
9700 MACKENZIE RD STE 105, SAINT LOUIS, MO 63123(314) 638-9100 Get Directions Write a Review

NPPES record last updated: August 28, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southside Medical Group Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSIDE MEDICAL GROUP PC (NPI 1912101486) is a healthcare organization registered as a specialist in Saint Louis, Missouri and active in the NPI registry since June 2007. The organization lists Subodh K Mehra, Doctor, as its authorized official.

NPPES Registry Identity

NPI1912101486
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHSIDE MEDICAL GROUP PC
Location Address9700 MACKENZIE RD STE 105Saint Louis, MO 63123-5423
Mailing Address9700 Mackenzie Rd Ste 105Saint Louis, MO 63123-5423 · (314) 638-9100
Phone(314) 638-9100
Organization SubpartNo
Authorized OfficialSubodh K MehraDoctor · (314) 638-9100
Enumeration DateJune 11, 2007
Last NPPES UpdateAugust 28, 2009
✔ NPI 1912101486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MO · R77046
Definition
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.
9700 MACKENZIE RD STE 105, Saint Louis, MO 63123
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southside Medical Group PC's NPI number?

The NPI number for Southside Medical Group PC is 1912101486. It was assigned to this organization in the NPPES registry on June 11, 2007.

Where is Southside Medical Group PC located?

Southside Medical Group PC is located at 9700 Mackenzie Rd Ste 105, Saint Louis, MO 63123. The listed phone number is (314) 638-9100.

What is Southside Medical Group PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southside Medical Group PC was last updated on August 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.