| Clinic Of Internal Medicine, Llc | |
|
121 Saint Lukes Center Dr Ste 506 Chesterfield MO 63017-3519 | |
| (314) 576-8102 | |
| (314) 590-5930 |
| Full Name | Clinic Of Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 121 Saint Lukes Center Dr Ste 506, Chesterfield, Missouri |
| Authorized Official Name and Position | James Snider (VP PHYSICIAN NETWORK) |
| Authorized Official Contact | 6366857804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinic Of Internal Medicine, Llc 232 S Woods Mill Rd Chesterfield MO 63017-3406 Ph: (636) 685-7804 | Clinic Of Internal Medicine, Llc 121 Saint Lukes Center Dr Ste 506 Chesterfield MO 63017-3519 Ph: (314) 576-8102 |
| NPI Number | 1316053077 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 07/23/2021 |
| Medicare PECOS PAC ID | 6305870361 |
|---|---|
| Medicare Enrollment ID | O20050920000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316053077 | NPI | - | NPPES |
| DD7565 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RR0500X | Internal Medicine - Rheumatology | (* (Not Available)) | Secondary |
| Provider Name | Mohammad M Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386636447 PECOS PAC ID: 2365347275 Enrollment ID: I20040727000133 |
| Provider Name | Rand W Sommer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861484784 PECOS PAC ID: 0749214906 Enrollment ID: I20050927000232 |
| Provider Name | Randa Sawaf Hajji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437363553 PECOS PAC ID: 3678673555 Enrollment ID: I20070706000134 |
| Provider Name | Anita M Detchemendy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225586936 PECOS PAC ID: 5092003848 Enrollment ID: I20161011000398 |
| Provider Name | Kyle Branson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376169433 PECOS PAC ID: 7416311352 Enrollment ID: I20230912000985 |
Maryland Medical Group Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 S Woods Mill Rd, Suite 350n, Chesterfield, MO 63017 Phone: 314-205-6557 | |
Physician Affiliates Of St. Luke's Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Saint Lukes Center Dr, Chesterfield, MO 63017 Phone: 314-576-2475 | |
Digestive Consultants Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 222 S Woods Mill Rd Ste 410, Chesterfield, MO 63017 Phone: 636-685-7795 Fax: 314-590-5959 | |
Wuca Woods Mill Pediatrics, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 S Woods Mill Rd, Suite 36w, Chesterfield, MO 63017 Phone: 314-453-9666 | |
Palm Valley Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1095 Nooning Tree Dr, Chesterfield, MO 63017 Phone: 314-800-6980 | |
Diagnostic Internists, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 224 S Woods Mill Rd, 410 S, Chesterfield, MO 63017 Phone: 314-878-7220 Fax: 314-878-0047 | |
County Internal Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 224 S Woods Mill Rd, Suite 370 South, Chesterfield, MO 63017 Phone: 314-628-9994 |