Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 108274 | MO |
Y | 208000000X | Pediatrician | 108274 | MO |
NPI | 1003861543 |
---|---|
Provider Name | Christopher Sallee |
First Address | Saint Louis, MO 63104-1003 |
Second Address | St. Louis, MO 63104-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I00952 | (02) | MO |