Edwardo D Verzola Md Pc | |
1004 Herculaneum Industrial Dr Herculaneum MO 63048-1507 | |
(636) 937-8675 | |
(636) 933-1981 |
Full Name | Edwardo D Verzola Md Pc |
---|---|
Speciality | Internal Medicine - Gastroenterology |
Location | 1004 Herculaneum Industrial Dr, Herculaneum, Missouri |
Authorized Official Name and Position | Edwardo D Verzola (CEO) |
Authorized Official Contact | 6369378675 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Edwardo D Verzola Md Pc 1004 Herculaneum Industrial Dr P O Box 127 Herculaneum MO 63048-1507 Ph: (636) 937-8675 | Edwardo D Verzola Md Pc 1004 Herculaneum Industrial Dr Herculaneum MO 63048-1507 Ph: (636) 937-8675 |
NPI Number | 1043548506 |
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Provider Enumeration Date | 11/20/2009 |
Last Update Date | 11/20/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043548506 | NPI | - | NPPES |
00094938 | Other | MEDICARE PROVIDER # | |
2000161966 | Other | MO | MO LICENSE |
VE205099708 | Medicaid | MO | |
10856311 | Other | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | 2000161966 (Missouri) | Primary |
Compass Health, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Senn Tomas Dr, Herculaneum, MO 63048 Phone: 636-277-6096 Fax: 636-224-6776 |