Provider Demographics
NPI:1043222706
Name:UNIVERSITY INTERNISTS OF ST LOUIS INC
Entity Type:Organization
Organization Name:UNIVERSITY INTERNISTS OF ST LOUIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-845-9339
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-0209
Mailing Address - Country:US
Mailing Address - Phone:314-845-9339
Mailing Address - Fax:
Practice Address - Street 1:5000 CEDAR PLAZA PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3854
Practice Address - Country:US
Practice Address - Phone:314-845-9339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCN7399OtherRAILROAD MEDICARE
MOCN7399OtherRAILROAD MEDICARE