| Alyve Medical Pllc Family Medical Clinic | |
|
1480 N Green Mount Rd Ste 200 O Fallon IL 62269-3466 | |
| (618) 622-3450 | |
| (618) 622-3468 |
| Full Name | Alyve Medical Pllc Family Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 1480 N Green Mount Rd Ste 200, O Fallon, Illinois |
| Authorized Official Name and Position | Amardeep Shrestha (MANAGER) |
| Authorized Official Contact | 2178018156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alyve Medical Pllc Family Medical Clinic 783 Allenbrook Ave O Fallon IL 62269-7455 Ph: (217) 801-8156 | Alyve Medical Pllc Family Medical Clinic 1480 N Green Mount Rd Ste 200 O Fallon IL 62269-3466 Ph: (618) 622-3450 |
| NPI Number | 1295495208 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 01/06/2022 |
| Medicare PECOS PAC ID | 2961896519 |
|---|---|
| Medicare Enrollment ID | O20220225000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295495208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RB0002X | Internal Medicine - Obesity Medicine | (* (Not Available)) | Primary |
| Provider Name | Amardeep Shrestha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730490525 PECOS PAC ID: 2668611575 Enrollment ID: I20130625000208 |
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