Laura Elizabeth Holzum, MD | |
3878 Pershall Rd, Ferguson, MO 63135-1246 | |
(314) 839-7500 | |
Not Available |
Full Name | Laura Elizabeth Holzum |
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Gender | Female |
Speciality | Pediatrics |
Location | 3878 Pershall Rd, Ferguson, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770870776 | NPI | - | NPPES |
036134840 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036-134840 (Illinois) | Secondary |
208000000X | Pediatrics | 2019042541 (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 |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174577670 PECOS PAC ID: 7012828163 Enrollment ID: O20031231000604 |
Mailing Address | Practice Location Address |
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Laura Elizabeth Holzum, MD 3878 Pershall Rd, Ferguson, MO 63135-1246 Ph: (314) 839-7500 | Laura Elizabeth Holzum, MD 3878 Pershall Rd, Ferguson, MO 63135-1246 Ph: (314) 839-7500 |
Dr. April L. Tyus-myles, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3878 Pershall Rd, Ferguson, MO 63135 Phone: 314-839-7500 Fax: 314-839-8545 | |
Erica Harris-herron, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3878 Pershall Rd, Ferguson, MO 63135 Phone: 314-839-7500 | |
Dr. Shesha Kalyan Katakam, MD, MPH Pediatrics Medicare: Medicare Enrolled Practice Location: 3878 Pershall Rd, Ferguson, MO 63135 Phone: 314-839-7500 |