| Great Plains Endocrinology & Diabetes Care Llc | |
|
15421 Clayton Rd Ste 202 Ballwin MO 63011-3161 | |
| (636) 534-1466 | |
| Not Available |
| Full Name | Great Plains Endocrinology & Diabetes Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15421 Clayton Rd Ste 202, Ballwin, Missouri |
| Authorized Official Name and Position | Azra Niaz (OWNER) |
| Authorized Official Contact | 7739712604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Plains Endocrinology & Diabetes Care Llc 15421 Clayton Rd Ste 202 Ballwin MO 63011-3161 Ph: (636) 534-1466 | Great Plains Endocrinology & Diabetes Care Llc 15421 Clayton Rd Ste 202 Ballwin MO 63011-3161 Ph: (636) 534-1466 |
| NPI Number | 1962275750 |
|---|---|
| Provider Enumeration Date | 11/02/2023 |
| Last Update Date | 11/30/2023 |
| Medicare PECOS PAC ID | 8921457441 |
|---|---|
| Medicare Enrollment ID | O20231209000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962275750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Azra Niaz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992155105 PECOS PAC ID: 8527390079 Enrollment ID: I20231209000237 |
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