Affton Medical Clinic
Pediatric Adolescent Medicine
Affton Medical Clinic is a Saint Louis, Missouri based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
59 Grasso Plz, Saint Louis, Missouri - 63123-3107. They can be contacted on phone at
314-638-9309 and fax number 314-638-9333.
NPI number (Unique professional ID) for Affton Medical Clinic is
1114048154 which was assigned by NPPES on 03 Apr, 2007 and it was last updated on 16 Jun, 2008.
Affton Medical Clinic license number is
R5P40 for Pediatrics Adolescent Medicine (2080A0000X) in Missouri.
Affton Medical Clinic specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Affton Medical Clinic basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Affton Medical Clinic |
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Business Address:
Affton Medical Clinic address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 59 Grasso Plz
Saint Louis, MO, 63123-3107
United States |
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| Phone Number : | 314-638-9309 |
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| Fax Number : | 314-638-9333 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1114048154 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 03 Apr, 2007 |
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| Last Updated On : | 16 Jun, 2008 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Rubilindagimena Casino |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | MEDICAL DIRECTOR |
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| Phone Number : | 314-638-9309 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Affton Medical Clinic are as mentioned. Primary taxonomy code for Affton Medical Clinic is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | R5P40 | MO |
Legacy Identifiers:
Other legacy medical identifiers of Affton Medical Clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 205357908 | MEDICAID | MO | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 59 Grasso Plz
Saint Louis, MO, 63123-3107
United States |
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| Phone Number : | 314-638-9309 |
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| Fax Number : | 314-638-9333 |
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Business Location:
Patients can refer following map for directions to
Affton Medical Clinic practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.