| Id Consultants, P.c. | |
|
1400 Us Highway 61 Ste 260 Festus MO 63028-4101 | |
| (636) 933-2344 | |
| (636) 937-9031 |
| Full Name | Id Consultants, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1400 Us Highway 61 Ste 260, Festus, Missouri |
| Authorized Official Name and Position | Chandra B. Dommaraju (PRESIDENT) |
| Authorized Official Contact | 6369332344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Consultants, P.c. 1400 Us Highway 61 Ste 260 Festus MO 63028-4101 Ph: (636) 933-2344 | Id Consultants, P.c. 1400 Us Highway 61 Ste 260 Festus MO 63028-4101 Ph: (636) 933-2344 |
| NPI Number | 1023113438 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 04/26/2021 |
| Medicare PECOS PAC ID | 6608876024 |
|---|---|
| Medicare Enrollment ID | O20070109000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023113438 | NPI | - | NPPES |
| 1578866596 | Other | MO | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | MO106962 (Missouri) | Primary |
| Provider Name | Chandra B Dommaraju |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255361135 PECOS PAC ID: 7315963741 Enrollment ID: I20051017000191 |
Comtrea Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 S 2nd St, Festus, MO 63028 Phone: 636-931-2700 | |
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Gastroenterology And Liver Consultants Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W Main St, Festus, MO 63028 Phone: 636-931-2320 Fax: 636-937-9693 | |
Southern Missouri Infectious Disease Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1447 Us Highway 61 Ste C, Festus, MO 63028 Phone: 636-375-4153 Fax: 636-333-4510 | |
Mercy Clinic Adult Hospitalists- Jefferson, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1400 Us Highway 61, Festus, MO 63028 Phone: 314-364-4200 | |
South County Internal Medicine Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1479 Highway 61, Suite A, Festus, MO 63028 Phone: 636-579-6148 Fax: 888-756-6714 |