1598776601 NPI number — DAVID SCOTT GERMAN MD

Table of content: DAVID SCOTT GERMAN MD (NPI 1598776601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598776601 NPI number — DAVID SCOTT GERMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GERMAN
Provider First Name:
DAVID
Provider Middle Name:
SCOTT
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:
1598776601
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
621 SOUTH NEW BALLAS ROAD
Provider Second Line Business Mailing Address:
SUITE 6003B
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-991-2151
Provider Business Mailing Address Fax Number:
314-991-2742

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
621 SOUTH NEW BALLAS ROAD
Provider Second Line Business Practice Location Address:
SUITE 6003B
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-991-2151
Provider Business Practice Location Address Fax Number:
314-991-2742
Provider Enumeration Date:
08/11/2006

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: 208200000X , with the licence number:  R3G63 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2082S0105X , with the licence number: R3G63 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000002612 . This is a "HUMANA GOLD CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: E61059 . This is a "MERCY HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110092374 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 23802 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: STL1300028 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6254V41192 . This is a "GROUP HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3105655001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6254V41192 . This is a "CARE MANAGEMENT RESOURCE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com