Organization Name: | WESTEND MEDICAL CENTER PC |
NPI Number: | 1316057565 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VALERIE O WALKER (MEDICAL DIRECTOR) |
Mailing Address: | 6125 Clayton Ave Ste 118 Saint Louis |
State: | MO US |
Postal Code: | 631393265 |
Phone Number: | 3143674044 |
Fax Number: | 3143671440 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 12/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | R9B43 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |