Provider Demographics
NPI:1609101849
Name:ST. MARY'S EMERGENCY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:ST. MARY'S EMERGENCY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:E
Authorized Official - Last Name:BICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-338-3550
Mailing Address - Street 1:3700 WASHINGTON AVE
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0541
Mailing Address - Country:US
Mailing Address - Phone:812-485-4491
Mailing Address - Fax:317-870-0499
Practice Address - Street 1:3700 WASHINGTON AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0541
Practice Address - Country:US
Practice Address - Phone:812-485-4491
Practice Address - Fax:317-870-0499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty