Provider Demographics
NPI:1407900640
Name:METROPOLITAN ORTHOPEDICS, LTD.
Entity Type:Organization
Organization Name:METROPOLITAN ORTHOPEDICS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-432-2323
Mailing Address - Street 1:P O BOX 790379
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179
Mailing Address - Country:US
Mailing Address - Phone:314-432-2323
Mailing Address - Fax:314-432-5328
Practice Address - Street 1:3009 N BALLAS RD
Practice Address - Street 2:SUITE 105B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-432-2323
Practice Address - Fax:314-432-5328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCS1990OtherRR MEDICARE
ILCH6219OtherRR MEDICARE IL
1073030001Medicare NSC