Provider Demographics
NPI:1699001040
Name:DAVID M. PEEPLES MD, LLC
Entity type:Organization
Organization Name:DAVID M. PEEPLES MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEEPLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-537-0525
Mailing Address - Street 1:PO BOX 952629
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-2629
Mailing Address - Country:US
Mailing Address - Phone:636-537-0525
Mailing Address - Fax:636-537-0575
Practice Address - Street 1:14825 NORTH OUTER 40
Practice Address - Street 2:SUITE 330A
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:636-537-0525
Practice Address - Fax:636-537-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3L662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty