Delmar Primary Care Associates Llc | |
5621 Delmar Blvd Suite 108 Saint Louis MO 63112 | |
(314) 833-3437 | |
(314) 833-3102 |
Full Name | Delmar Primary Care Associates Llc |
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Speciality | Clinic/Center |
Location | 5621 Delmar Blvd, Saint Louis, Missouri |
Authorized Official Name and Position | Dannie E Williams (GENERAL PRACTITIONER/OWNER) |
Authorized Official Contact | 3148333437 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Delmar Primary Care Associates Llc 5621 Delmar Blvd Suite 108 Saint Louis MO 63112-2656 Ph: (314) 833-3437 | Delmar Primary Care Associates Llc 5621 Delmar Blvd Suite 108 Saint Louis MO 63112 Ph: (314) 833-3437 |
NPI Number | 1326464298 |
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Provider Enumeration Date | 03/14/2014 |
Last Update Date | 07/10/2018 |
Medicare PECOS PAC ID | 8325265416 |
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Medicare Enrollment ID | O20140813002532 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326464298 | NPI | - | NPPES |
1568626349 | Other | MO | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 2013013940 (Missouri) | Primary |
Provider Name | Dannie E Williams |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568626349 PECOS PAC ID: 6406017680 Enrollment ID: I20130826000527 |
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