| Infectious Disease | |
|
10004 Kennerly Rd Ste 295b Saint Louis MO 63128-2177 | |
| (314) 740-2949 | |
| (314) 375-5020 |
| Full Name | Infectious Disease |
|---|---|
| Speciality | Internal Medicine |
| Location | 10004 Kennerly Rd Ste 295b, Saint Louis, Missouri |
| Authorized Official Name and Position | Suresh Nellore (MD) |
| Authorized Official Contact | 3147402949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease 842 N New Ballas Ct Unit 206 Saint Louis MO 63141-7153 Ph: (314) 487-8724 | Infectious Disease 10004 Kennerly Rd Ste 295b Saint Louis MO 63128-2177 Ph: (314) 740-2949 |
| NPI Number | 1225494628 |
|---|---|
| Provider Enumeration Date | 01/14/2016 |
| Last Update Date | 07/18/2024 |
| Medicare PECOS PAC ID | 2466758172 |
|---|---|
| Medicare Enrollment ID | O20160307001211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225494628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 108767 (Missouri) | Primary |
| Provider Name | Suresh Nellore |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1144297862 PECOS PAC ID: 2961431226 Enrollment ID: I20100320000251 |
| Provider Name | Swati S Patolia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982952560 PECOS PAC ID: 4183934557 Enrollment ID: I20151116000542 |
| Provider Name | Yuriko Mcallister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407390255 PECOS PAC ID: 5092088161 Enrollment ID: I20170912001868 |
| Provider Name | Ali Etemady-deylamy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760864888 PECOS PAC ID: 4486946076 Enrollment ID: I20190326001069 |
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