| Bahm Family Medicine Llc | |
|
2880 Netherton Dr Ste 200 Saint Louis MO 63136-4697 | |
| (314) 355-5300 | |
| (314) 521-4656 |
| Full Name | Bahm Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2880 Netherton Dr Ste 200, Saint Louis, Missouri |
| Authorized Official Name and Position | Akinrinola Fatoki (MEMBER) |
| Authorized Official Contact | 3143555300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bahm Family Medicine Llc Po Box 4204 Chesterfield MO 63006-4204 Ph: (314) 355-5300 | Bahm Family Medicine Llc 2880 Netherton Dr Ste 200 Saint Louis MO 63136-4697 Ph: (314) 355-5300 |
| NPI Number | 1184839136 |
|---|---|
| Provider Enumeration Date | 05/12/2007 |
| Last Update Date | 10/21/2024 |
| Medicare PECOS PAC ID | 7113028044 |
|---|---|
| Medicare Enrollment ID | O20070723000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184839136 | NPI | - | NPPES |
| 208030767 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 109044 (Missouri) | Primary |
| Provider Name | Akinrinola Fatoki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346354693 PECOS PAC ID: 2062309230 Enrollment ID: I20070731000158 |
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