| Arch Pediatrics | |
|
3844 S Lindbergh Blvd Ste 216 Saint Louis MO 63127-1369 | |
| (314) 525-0580 | |
| (314) 525-0581 |
| Full Name | Arch Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 3844 S Lindbergh Blvd Ste 216, Saint Louis, Missouri |
| Authorized Official Name and Position | Cathy Eghigian (DIRECTOR, CREDENTIALING OPERATIONS) |
| Authorized Official Contact | 3142730770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arch Pediatrics 3844 S Lindbergh Blvd Ste 216 Saint Louis MO 63127-1369 Ph: (314) 525-0580 | Arch Pediatrics 3844 S Lindbergh Blvd Ste 216 Saint Louis MO 63127-1369 Ph: (314) 525-0580 |
| NPI Number | 1275014953 |
|---|---|
| Provider Enumeration Date | 08/22/2018 |
| Last Update Date | 08/22/2018 |
| Medicare PECOS PAC ID | 1456605591 |
|---|---|
| Medicare Enrollment ID | O20181108001740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275014953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Maria V Ganninger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669532180 PECOS PAC ID: 1557256815 Enrollment ID: I20040217000536 |
| Provider Name | Robert Atteberry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376516245 PECOS PAC ID: 4385625698 Enrollment ID: I20040525000062 |
| Provider Name | Teresa T Dillard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689830168 PECOS PAC ID: 7012290398 Enrollment ID: I20170210001827 |
| Provider Name | Marti H Ianiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982780714 PECOS PAC ID: 0244594356 Enrollment ID: I20181204002197 |
| Provider Name | Steven R Mueth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376517086 PECOS PAC ID: 3375868748 Enrollment ID: I20181204002428 |
| Provider Name | Dean Thomas Odegard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518527043 PECOS PAC ID: 4688036189 Enrollment ID: I20230815004244 |
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