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PEDIATRIC UROLOGY SPECIALISTS PC NPI 1821256843


NPI Information

NPI: 1821256843
Provider Name: PEDIATRIC UROLOGY SPECIALISTS, PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 26D2038945

Address:
1465 S GRAND BLVD
ROOM 3709
SAINT LOUIS, MO
ZIP 63104
Phone: (314) 268-4154
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PEDIATRIC UROLOGY SPECIALISTS, PC is a pediatrics in Saint Louis, MO. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PEDIATRIC UROLOGY SPECIALISTS, PC NPI is 1821256843. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1465 S GRAND BLVD
ROOM 3709
SAINT LOUIS, MO
ZIP 63104-003
Phone: (314) 268-4154

The provider's authorized official is Casimir Firlit .
The authorized official title is Owner/managing Employee and has the following contact phone number (314) 268-4154.

The CLIA number assigned to this NPI record is 26D2038945 - other - university with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/27/2008 and was last updated on 5/27/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics2003025342MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1209196708MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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