Provider Demographics
NPI:1215504394
Name:TOP MEDICAL CENTER LP
Entity type:Organization
Organization Name:TOP MEDICAL CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRACHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BANERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-384-3600
Mailing Address - Street 1:456 N NEW BALLAS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6850
Mailing Address - Country:US
Mailing Address - Phone:314-384-3600
Mailing Address - Fax:
Practice Address - Street 1:456 N NEW BALLAS RD STE 101
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6850
Practice Address - Country:US
Practice Address - Phone:314-384-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty