| Internal Medicine, Llc | |
|
4346 Loughborough Ave Saint Louis MO 63116-2104 | |
| (314) 481-7030 | |
| (314) 481-7120 |
| Full Name | Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4346 Loughborough Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Alexander Rudoi (OWNER) |
| Authorized Official Contact | 3144817030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine, Llc 4346 Loughborough Ave Saint Louis MO 63116-2104 Ph: (314) 481-7030 | Internal Medicine, Llc 4346 Loughborough Ave Saint Louis MO 63116-2104 Ph: (314) 481-7030 |
| NPI Number | 1235389859 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 09/19/2008 |
| Medicare PECOS PAC ID | 8022176460 |
|---|---|
| Medicare Enrollment ID | O20081029000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235389859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alexander Rudoi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740254374 PECOS PAC ID: 2961480504 Enrollment ID: I20040710000172 |
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