Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Affton Medical Clinic

Organization Pediatric Adolescent Medicine Physician · NPI 1114048154

Affton Medical Clinic is a Pediatric Adolescent Medicine Physician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2007.

Licensed in
MO
In the registry since
2007

Practice location Address checks out

59 Grasso Plz
Saint Louis, MO 63123-3107
Phone: (314) 638-9309
Fax: (314) 638-9333
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X · Licence R5P40 (MO)

Record details

NPI number1114048154
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rubilinda Casino — Medical Director · (314) 638-9309
NPI enumeratedApril 3, 2007
Last updated in NPPESJune 16, 2008
Mailing address59 Grasso Plz, Saint Louis, MO 63123-3107

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