1407078827 NPI number — JAMES R SCHARFF MD

Table of content: JAMES R SCHARFF MD (NPI 1407078827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407078827 NPI number — JAMES R SCHARFF MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHARFF
Provider First Name:
JAMES
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1407078827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3023 N BALLAS RD STE 150D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63131-2319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-996-5287
Provider Business Mailing Address Fax Number:
314-432-6068

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3023 N BALLAS RD STE 150D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63131-2319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-996-5287
Provider Business Practice Location Address Fax Number:
314-432-6068
Provider Enumeration Date:
05/03/2007

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: 208G00000X , with the licence number:  2005017791 , 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)

  • Identifier: 207549700 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00463756 . This is a "RR MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".