Provider Demographics
NPI:1336826486
Name:STA MARIA, JOSEPH PASCASIO JR (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PASCASIO
Last Name:STA MARIA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:SSM HEALTH ST. MARY'S HOSPITAL, DEPARTMENT OF INTERNAL
Mailing Address - Street 2:6420 CLAYTON RD
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117
Mailing Address - Country:US
Mailing Address - Phone:314-768-8778
Mailing Address - Fax:
Practice Address - Street 1:SSM HEALTH ST. MARY'S HOSPITAL, DEPARTMENT OF INTERNAL
Practice Address - Street 2:6420 CLAYTON RD
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:314-768-8778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023014109390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program