Provider Demographics
NPI:1588814537
Name:SAINT LOUIS ASSOCIATES IN OBGYN, INC.
Entity Type:Organization
Organization Name:SAINT LOUIS ASSOCIATES IN OBGYN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-993-6401
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:1017B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-339-6401
Mailing Address - Fax:314-339-5475
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:1017B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-339-6401
Practice Address - Fax:314-339-5475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCR0966OtherRR MEDICARE