| Ksj Medical Llc | |
|
10010 Kennerly Rd Saint Louis MO 63128-2106 | |
| (314) 525-1000 | |
| (636) 333-4510 |
| Full Name | Ksj Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10010 Kennerly Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Khaled Jumean (OWNER) |
| Authorized Official Contact | 2014073489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ksj Medical Llc 23 Toddington Ter Saint Louis MO 63128-2632 Ph: (201) 407-3489 | Ksj Medical Llc 10010 Kennerly Rd Saint Louis MO 63128-2106 Ph: (314) 525-1000 |
| NPI Number | 1447849575 |
|---|---|
| Provider Enumeration Date | 01/13/2021 |
| Last Update Date | 03/15/2021 |
| Medicare PECOS PAC ID | 0143636498 |
|---|---|
| Medicare Enrollment ID | O20210310002699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447849575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Khaled Jumean |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134351448 PECOS PAC ID: 5294881611 Enrollment ID: I20090925000303 |
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