Provider Demographics
NPI:1235354143
Name:SEASONS HEALTHCARE FOR WOMEN
Entity Type:Organization
Organization Name:SEASONS HEALTHCARE FOR WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-849-3500
Mailing Address - Street 1:10004 KENNERLY RD
Mailing Address - Street 2:SUITE 395B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2141
Mailing Address - Country:US
Mailing Address - Phone:314-849-3500
Mailing Address - Fax:314-849-4422
Practice Address - Street 1:10004 KENNERLY RD
Practice Address - Street 2:SUITE 395B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2141
Practice Address - Country:US
Practice Address - Phone:314-849-3500
Practice Address - Fax:314-849-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODG6064OtherRAILROAD MEDICARE
MO000015359Medicare PIN