Basic Information
Provider Information
NPI: 1407956964
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ST. CLAIR
FirstName: TORRI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 37090
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212973090
CountryCode: US
TelephoneNumber: 7032959360
FaxNumber: 7032959369
Practice Location
Address1: 500 J CLYDE MORRIS BLVD
Address2:  
City: NEWPORT NEWS
State: VA
PostalCode: 236011929
CountryCode: US
TelephoneNumber: 7575942000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2006
LastUpdateDate: 04/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD00047191WAN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X0101248294VAY Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X38179AZN Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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