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

Southside Medical Group PC

Organization Specialist · NPI 1912101486

Southside Medical Group PC is a Specialist in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2007.

Licensed in
MO
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9700 Mackenzie Rd Ste 105
Saint Louis, MO 63123-5423
Phone: (314) 638-9100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence R77046 (MO)

Record details

NPI number1912101486
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Subodh Mehra — Doctor · (314) 638-9100
NPI enumeratedJune 11, 2007
Last updated in NPPESAugust 28, 2009
Mailing address9700 Mackenzie Rd Ste 105, Saint Louis, MO 63123-5423

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