1083938658 NPI number — ROBIN MCGEE HIS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083938658 NPI number — ROBIN MCGEE HIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGEE
Provider First Name:
ROBIN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
HIS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083938658
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 LAKE SAINT LOUIS BLVD STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE ST LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63367-2953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-856-3228
Provider Business Mailing Address Fax Number:
636-856-3228

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1728 CLARKSON RD
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63017-4976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-536-4422
Provider Business Practice Location Address Fax Number:
636-456-5454
Provider Enumeration Date:
03/25/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  2002012706 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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