FAIRVIEW HEIGHTS MEDICAL GROUP SC

BRIDGETON, MO
NPI1407912736
Entity TypeOrganization
Authorized ContactJOHN ELLENA
Medical Director
314-434-8828
Organization Subpart ?No
Primary Taxonomy261QM2500X Clinic/Center, Medical Specialty
Enumeration Date2006-12-29
Last Update Date2020-08-22
Business Address
FAIRVIEW HEIGHTS MEDICAL GROUP SC
3165 MCKELVEY RD 210
BRIDGETON, MO 63044-2550
Phone number: 314-996-8148
Mailing Address
FAIRVIEW HEIGHTS MEDICAL GROUP SC
11155 DUNN RD 108N
SAINT LOUIS, MO 63136-6150
Phone number: 314-355-6779
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