Provider Demographics
NPI:1093826166
Name:METROPOLITAN OCCUPATIONAL MEDICINE P.C.
Entity Type:Organization
Organization Name:METROPOLITAN OCCUPATIONAL MEDICINE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-298-7200
Mailing Address - Street 1:13613 LAKEFRONT DR
Mailing Address - Street 2:
Mailing Address - City:EARTH CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63045-1404
Mailing Address - Country:US
Mailing Address - Phone:314-298-7200
Mailing Address - Fax:314-298-7207
Practice Address - Street 1:13613 LAKEFRONT DR
Practice Address - Street 2:
Practice Address - City:EARTH CITY
Practice Address - State:MO
Practice Address - Zip Code:63045-1404
Practice Address - Country:US
Practice Address - Phone:314-298-7200
Practice Address - Fax:314-298-7207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC45067Medicare UPIN