| Vadim Baram Md, Inc. | |
|
10420 Old Olive Street Rd Ste 205 Saint Louis MO 63141-5937 | |
| (314) 692-8516 | |
| (314) 692-9978 |
| Full Name | Vadim Baram Md, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10420 Old Olive Street Rd Ste 205, Saint Louis, Missouri |
| Authorized Official Name and Position | Caren Zinn (OFFICE MANAGER) |
| Authorized Official Contact | 3146928516 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vadim Baram Md, Inc. 10420 Old Olive Street Rd Ste 205 Saint Louis MO 63141-5937 Ph: (314) 692-8516 | Vadim Baram Md, Inc. 10420 Old Olive Street Rd Ste 205 Saint Louis MO 63141-5937 Ph: (314) 692-8516 |
| NPI Number | 1770743189 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 09/25/2020 |
| Certification Date | 09/25/2020 |
| Medicare PECOS PAC ID | 4486725595 |
|---|---|
| Medicare Enrollment ID | O20080617000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770743189 | NPI | - | NPPES |
| 209106806 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 2004022302 (Missouri) | Primary |
| Provider Name | Vadim Y Baram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124007380 PECOS PAC ID: 3577518299 Enrollment ID: I20050316000023 |
| Provider Name | Chandrashekar Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285784850 PECOS PAC ID: 3779514047 Enrollment ID: I20050826000018 |
| Provider Name | Julie Lynne Waterbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447552260 PECOS PAC ID: 5496936106 Enrollment ID: I20120516000672 |
| Provider Name | Alexander E Graypel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871804914 PECOS PAC ID: 8325369812 Enrollment ID: I20150609002406 |
| Provider Name | Judy A Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023566551 PECOS PAC ID: 2466733324 Enrollment ID: I20170109000551 |
| Provider Name | Debra Seiffert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366950925 PECOS PAC ID: 0244589083 Enrollment ID: I20180828000574 |
| Provider Name | Miles Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760948574 PECOS PAC ID: 5698001923 Enrollment ID: I20190724003501 |
| Provider Name | Katie Miley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780206797 PECOS PAC ID: 4587084306 Enrollment ID: I20201016001508 |
| Provider Name | Anna Hien Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104423250 PECOS PAC ID: 9436579083 Enrollment ID: I20201020001617 |
| Provider Name | Megan Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134609324 PECOS PAC ID: 7113332727 Enrollment ID: I20210211003417 |
| Provider Name | Aldijana Sacic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740807825 PECOS PAC ID: 6709285950 Enrollment ID: I20210520002346 |
| Provider Name | Britney Kneibert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205599545 PECOS PAC ID: 5193110583 Enrollment ID: I20220322001443 |
| Provider Name | Jasmina Terzic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962154690 PECOS PAC ID: 3375922016 Enrollment ID: I20220627000580 |
| Provider Name | Anastasia Amiramova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982327987 PECOS PAC ID: 7012387558 Enrollment ID: I20221228001102 |
| Provider Name | Yevgeniya O Mykhaylevska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548974066 PECOS PAC ID: 3678948122 Enrollment ID: I20230414000400 |
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