Provider Demographics
NPI:1760569131
Name:POPP, DENNIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:POPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:3006
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-6020
Mailing Address - Fax:314-251-5952
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:3006
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-6020
Practice Address - Fax:314-251-5952
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
MOR8126207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA10048Medicare UPIN
MO1732Medicare ID - Type Unspecified