Provider Demographics
NPI:1629179445
Name:ENDOCRINE CONSULTANTS LLC
Entity Type:Organization
Organization Name:ENDOCRINE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-441-7174
Mailing Address - Street 1:70 JUNGERMANN CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1622
Mailing Address - Country:US
Mailing Address - Phone:636-441-7174
Mailing Address - Fax:636-441-0568
Practice Address - Street 1:70 JUNGERMANN CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1622
Practice Address - Country:US
Practice Address - Phone:636-441-7174
Practice Address - Fax:636-441-0568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO19074131207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty