| David J. Pernikoff, Md, Pc | |
|
2865 Netherton Dr Saint Louis MO 63136-4674 | |
| (314) 653-1600 | |
| Not Available |
| Full Name | David J. Pernikoff, Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2865 Netherton Dr, Saint Louis, Missouri |
| Authorized Official Name and Position | David J. Pernikoff (PRESIDENT) |
| Authorized Official Contact | 3146531600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J. Pernikoff, Md, Pc Po Box 419161 Creve Coeur MO 63141-9141 Ph: (314) 432-2580 | David J. Pernikoff, Md, Pc 2865 Netherton Dr Saint Louis MO 63136-4674 Ph: (314) 653-1600 |
| NPI Number | 1952596314 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 02/22/2008 |
| Medicare PECOS PAC ID | 7618064775 |
|---|---|
| Medicare Enrollment ID | O20071106000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952596314 | NPI | - | NPPES |
| 506345107 | Medicaid | MO | |
| DG4189 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MO36099 (Missouri) | Primary |
| Provider Name | David J Pernikoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205820594 PECOS PAC ID: 9638266794 Enrollment ID: I20071106000558 |
| Provider Name | Edward A Puro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356409957 PECOS PAC ID: 3375540719 Enrollment ID: I20110915000883 |
| Provider Name | Meredith A Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457877979 PECOS PAC ID: 6608141932 Enrollment ID: I20171012000261 |
| Provider Name | Emily E Epley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912418773 PECOS PAC ID: 8527327311 Enrollment ID: I20180124003116 |
| Provider Name | Christina M Yeast |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851952345 PECOS PAC ID: 3577892108 Enrollment ID: I20190907000158 |
| Provider Name | Chloe S Datillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366096703 PECOS PAC ID: 8325378185 Enrollment ID: I20190923000895 |
| Provider Name | Kendra Maxey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285411603 PECOS PAC ID: 8426404674 Enrollment ID: I20231025001156 |
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