Edelmed Llc | |
12371 Mulberry Tree Ct Creve Coeur MO 63141-5470 | |
(636) 942-2223 | |
(636) 942-2223 |
Full Name | Edelmed Llc |
---|---|
Speciality | Internal Medicine |
Location | 12371 Mulberry Tree Ct, Creve Coeur, Missouri |
Authorized Official Name and Position | Adam J Edelman (OWNER) |
Authorized Official Contact | 3146147794 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Edelmed Llc 12371 Mulberry Tree Ct Creve Coeur MO 63141-5470 Ph: (636) 942-2223 | Edelmed Llc 12371 Mulberry Tree Ct Creve Coeur MO 63141-5470 Ph: (636) 942-2223 |
NPI Number | 1467784843 |
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Provider Enumeration Date | 02/09/2010 |
Last Update Date | 02/09/2010 |
Medicare PECOS PAC ID | 9830228121 |
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Medicare Enrollment ID | O20100525000592 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467784843 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 2003027198 (Missouri) | Primary |
Provider Name | Adam J Edelman |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1649384090 PECOS PAC ID: 5597866145 Enrollment ID: I20070726000096 |
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