| Ehab M Kaiser, Md, Llc | |
|
2 Mcknight Pl Saint Louis MO 63124-1900 | |
| (314) 434-1600 | |
| (314) 463-4466 |
| Full Name | Ehab M Kaiser, Md, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2 Mcknight Pl, Saint Louis, Missouri |
| Authorized Official Name and Position | Ehab Kaiser (PRESIDENT) |
| Authorized Official Contact | 3147804785 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ehab M Kaiser, Md, Llc Po Box 410121 Saint Louis MO 63141-0121 Ph: (314) 578-0478 | Ehab M Kaiser, Md, Llc 2 Mcknight Pl Saint Louis MO 63124-1900 Ph: (314) 434-1600 |
| NPI Number | 1306922141 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 01/13/2023 |
| Medicare PECOS PAC ID | 0042225468 |
|---|---|
| Medicare Enrollment ID | O20060207000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306922141 | NPI | - | NPPES |
| 500505706 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2000157953 (Missouri) | Primary |
| Provider Name | Ehab Kaiser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205804796 PECOS PAC ID: 6002863354 Enrollment ID: I20050407001105 |
| Provider Name | Victoria L Hines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013424530 PECOS PAC ID: 6901167063 Enrollment ID: I20180306001535 |
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