1841218328 NPI number — PAULA Y GEORGE MD

Table of content: PAULA Y GEORGE MD (NPI 1841218328)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841218328 NPI number — PAULA Y GEORGE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEORGE
Provider First Name:
PAULA
Provider Middle Name:
Y
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1841218328
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3691 RUTGER ST
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:
63110-2515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-977-5782
Provider Business Mailing Address Fax Number:
314-977-1628

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 S GRAND BLVD
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:
63104-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-257-5555
Provider Business Practice Location Address Fax Number:
314-257-5556
Provider Enumeration Date:
07/17/2006

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: 2085R0202X , with the licence number:  2002026771 , 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: 140894000 . This is a "DOL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205998222 . This is a "MO CAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 537465 . This is a "HL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 193990 . This is a "MO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2095276 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25010487 . This is a "MO CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4316563150PE . This is a "MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 26632 . This is a "GHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 65276 . This is a "GHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 686 . This is a "B CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: F58916 . This is a "MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 140893300 . This is a "DOL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 193990 . This is a "B CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205998214 . This is a "MO CAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2002026771 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 686 . This is a "MO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6668 . This is a "GHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 872 . This is a "HEALTHCARE US" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com