Provider Demographics
NPI:1922130848
Name:MISSOURI INTERNISTS
Entity Type:Organization
Organization Name:MISSOURI INTERNISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO VICE PRESIDENT OF MED AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:HINTZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-251-1955
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 142A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-5780
Mailing Address - Fax:314-251-4466
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 142A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-5780
Practice Address - Fax:314-251-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty