| Gastroenterology Care Llc | |
|
522 N New Ballas Rd Ste 210 Saint Louis MO 63141-6829 | |
| (314) 724-1348 | |
| Not Available |
| Full Name | Gastroenterology Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 522 N New Ballas Rd Ste 210, Saint Louis, Missouri |
| Authorized Official Name and Position | Kishore Maganty (PHYSICIAN OWNER) |
| Authorized Official Contact | 3147241348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Care Llc 18 Ladue Ct Saint Louis MO 63141-7803 Ph: (314) 724-1348 | Gastroenterology Care Llc 522 N New Ballas Rd Ste 210 Saint Louis MO 63141-6829 Ph: (314) 724-1348 |
| NPI Number | 1417598947 |
|---|---|
| Provider Enumeration Date | 10/06/2019 |
| Last Update Date | 10/06/2019 |
| Medicare PECOS PAC ID | 4385076819 |
|---|---|
| Medicare Enrollment ID | O20191121000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417598947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Kishore Maganty |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790908820 PECOS PAC ID: 7719085380 Enrollment ID: I20130726000535 |
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