Provider Demographics
NPI:1982889861
Name:DAVIS, WRIGHT, BERDY & SUFFIAN PC
Entity Type:Organization
Organization Name:DAVIS, WRIGHT, BERDY & SUFFIAN PC
Other - Org Name:ALLERGY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-569-1881
Mailing Address - Street 1:456 N NEW BALLAS RD
Mailing Address - Street 2:SUITE 129
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6831
Mailing Address - Country:US
Mailing Address - Phone:314-569-1881
Mailing Address - Fax:314-569-3277
Practice Address - Street 1:5551 WINGHAVEN BLVD STE 270
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-3629
Practice Address - Country:US
Practice Address - Phone:314-569-1881
Practice Address - Fax:314-569-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty