| Family Medicine - Slmg South, Llc | |
|
1501 Professional Dr Imperial MO 63052-3809 | |
| (636) 464-4000 | |
| (636) 529-0699 |
| Full Name | Family Medicine - Slmg South, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1501 Professional Dr, Imperial, Missouri |
| Authorized Official Name and Position | James Snider (VP PHYSICIAN NETWORK) |
| Authorized Official Contact | 6366857804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine - Slmg South, Llc 121 Saint Lukes Center Dr Chesterfield MO 63017-3518 Ph: (636) 685-7804 | Family Medicine - Slmg South, Llc 1501 Professional Dr Imperial MO 63052-3809 Ph: (636) 464-4000 |
| NPI Number | 1164077822 |
|---|---|
| Provider Enumeration Date | 08/08/2019 |
| Last Update Date | 10/21/2020 |
| Medicare PECOS PAC ID | 3971833443 |
|---|---|
| Medicare Enrollment ID | O20190925003479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164077822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nicole E Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235340332 PECOS PAC ID: 6204908007 Enrollment ID: I20080711000086 |
| Provider Name | Patrick R Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093715096 PECOS PAC ID: 4385711886 Enrollment ID: I20080925000331 |
| Provider Name | Patricia L Pitman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083915771 PECOS PAC ID: 1153519061 Enrollment ID: I20101220000444 |
| Provider Name | Melissa Ann Muench |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104266733 PECOS PAC ID: 0244536837 Enrollment ID: I20160718000234 |
| Provider Name | Rebecca A Michels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184144065 PECOS PAC ID: 2365712890 Enrollment ID: I20201125002468 |
Celso F Rodrigues Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2674 Fox Run Dr, Imperial, MO 63052 Phone: 636-461-2711 Fax: 636-461-0786 | |
Patterson Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1502 Prehistoric Hill Dr, Imperial, MO 63052 Phone: 636-464-4000 Fax: 636-464-4911 |