Basic Information
| Provider Information | |||||||||
| NPI: | 1588983209 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIOS MORALES | ||||||||
| FirstName: | PEDRO | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 S. EUCLID AVE CB 8054 | ||||||||
| Address2: | DEPT OF ANESTHESIOLOGY | ||||||||
| City: | ST. LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009862199 | ||||||||
| FaxNumber: | 3143621185 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E CARPENTER ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627691081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175446464 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2010 | ||||||||
| LastUpdateDate: | 12/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 2018008657 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 036156279 | IL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.