OrganizationActive
Endoscopy Center of St. Louis
NPI 1023094836 · Endoscopy Clinic/Center · Lake Saint Louis, MO
Provider details
- NPI number
- 1023094836
- Entity type
- Organization
- Primary specialty
- Endoscopy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- James Petersen, President(636) 561-5450
- License
- 152-0 (MO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
200 Brevco Plaza
Suite 207
Lake Saint Louis, MO 63367
Phone: (636) 561-5450
Fax: (636) 561-5451
Approximate (ZIP-level) locationGet directions
Mailing address
200 Brevco Plz
Lake Saint Louis, MO 63367-2947
Registry dates
- Enumerated
- 2005-12-22
- Last updated
- 2007-11-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.