Basic Information
| Provider Information | |||||||||
| NPI: | 1194912956 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT LOUIS UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7514 FLETA ST | ||||||||
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| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631232829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144893123 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3635 VISTA AVE | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631102539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145778000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2007 | ||||||||
| LastUpdateDate: | 09/26/2007 | ||||||||
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| AuthorizedOfficialLastName: | ABU-ROMEH | ||||||||
| AuthorizedOfficialFirstName: | OMAR | ||||||||
| AuthorizedOfficialMiddleName: | SALEH | ||||||||
| AuthorizedOfficialTitleorPosition: | PGY2 | ||||||||
| AuthorizedOfficialTelephone: | 3144893123 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2006019866 | MO | Y | Hospitals | General Acute Care Hospital |
No ID Information.