Dr Amanda Groebl Judilla, MD | |
515 N Virginia Ave, Eureka, MO 63025-1115 | |
(636) 587-3000 | |
Not Available |
Full Name | Dr Amanda Groebl Judilla |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 515 N Virginia Ave, Eureka, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225324569 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2014015412 (Missouri) | Primary |
Entity Name | Ssm Health Care St Louis |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275586174 PECOS PAC ID: 7810800737 Enrollment ID: O20031118000393 |
Entity Name | Ssm Cardinal Glennon Children's Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174577670 PECOS PAC ID: 7012828163 Enrollment ID: O20031231000604 |
Entity Name | Phelps County Regional Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891766051 PECOS PAC ID: 2860391158 Enrollment ID: O20040106000405 |
Entity Name | Pcrmc Medical Group, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124237227 PECOS PAC ID: 1557454063 Enrollment ID: O20070829000437 |
Mailing Address | Practice Location Address |
---|---|
Dr Amanda Groebl Judilla, MD 515 N Virginia Ave, Eureka, MO 63025-1115 Ph: (636) 587-3000 | Dr Amanda Groebl Judilla, MD 515 N Virginia Ave, Eureka, MO 63025-1115 Ph: (636) 587-3000 |
Doug S Nozaki, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 515 N Virginia Ave, Eureka, MO 63025 Phone: 636-587-3000 Fax: 636-587-3000 | |
Ted Allen Green, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 515 N Virginia Ave, Eureka, MO 63025 Phone: 636-587-3000 Fax: 636-587-2243 |